Medicare Post-Acute Care Value-Based Purchasing Act of 2015

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

HR 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 7154 - Outpatient Therapy Modernization and Stabilization Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections)

Client expense: $316,000 · Firm income: Not reported

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

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018 S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act S.2943, Quality Care for Nursing Home Residents Act of 2019 HR 6800 HEROES Act S. 3768 Nursing Home COVID-19 Protection and Prevention Act of 2020. S. 4108 A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns, and for other purposes. S.3644 Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. S.2943 Quality Care for Nursing Home Residents Act of 2019. H.R. 748 CARES Act H.R. 6201 Families First Coronavirus Response Act H.R. 7048 Nursing Home Pandemic Protection Act H.R.6872 - SOS Act of 2020 H.R. 6849 Nursing Facility Quality Reporting Act of 2020 H.R. 6847 COHORT Act of 2020 Public Health Fund Distribution to HHS as agency CMS on Public Health Waiver and other waivers

Client expense: $860,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR. 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR. 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR. 7154 - Outpatient Therapy Modernization and Stabilization Act (all sections)

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

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

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22.

Client expense: Not reported · Firm income: Not reported

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018 S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act S.2943, Quality Care for Nursing Home Residents Act of 2019

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (Division B - Relief for Individuals, Families, and Businesses; Division D - Health Care Response)

Client expense: $520,000 · Firm income: Not reported

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

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22.

Client expense: Not reported · Firm income: Not reported

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018 S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections) S. 296 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 2150 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections)

Client expense: $520,000 · Firm income: Not reported

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

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections) S. 296 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 2150 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections)

Client expense: $310,000 · Firm income: Not reported

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

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22.

Client expense: Not reported · Firm income: Not reported

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections) S. 296 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 2150 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program)

Client expense: $770,000 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the implementation of the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $1,060,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes

Client expense: Not reported · Firm income: Not reported

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the implementation of the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $1,060,000 · Firm income: Not reported

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

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes

Client expense: Not reported · Firm income: Not reported

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections)

Client expense: $560,000 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $970,000 · 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)

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 2204 - Preserving Rehabilitation Innovation Centers Act of 2017 (all sections)

Client expense: $570,000 · Firm income: Not reported

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

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections)

Client expense: $450,000 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CAN bill)

Client expense: $980,000 · 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)

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections)

Client expense: $460,000 · Firm income: Not reported

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

340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c).

Client expense: $920,000 · 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)

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017)

Client expense: $330,000 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141

Client expense: $990,000 · Firm income: Not reported

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017)

Client expense: $740,000 · Firm income: Not reported

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

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process

Client expense: $1,040,000 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process

Client expense: $900,000 · Firm income: Not reported

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

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections) S. 2368 Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (all sections) HR. 2029 Consolidated Appropriations Act, 2016 (Title II, Section 231 - LTAC Wound Criteria; Title V, Section 504 - HH Disposable Devices) HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes S.3107 - A bill to amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) H.R.5559 - To amend section 1206 of the Pathway for SGR Reform Act of 2013 to clarify the application of rules on the calculation of hospital length of stay to certain moratorium-excepted long-term care hospitals (LTCHs) (all sections) H.R.5273 - Helping Hospitals Improve Patient Care Act of 2016 (TITLE 1, (Sec. 104) With respect to long-term care hospitals, the bill lifts a moratorium on bed increases. The bill reduces rates for high-cost outlier payments, which are additional Medicare payments made in extraordinarily high-cost cases.) HR 5688 - To amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) S.3096 - Removing Barriers to Person-Centered Care Act of 2016 (all sections) S. 3130 - Independence at Home Act of 2016 (all sections) HR34 - 21st Century CURES Act, Title XV - Provisions Relations to Medicare Part A (Sec. 15004. Regulatory relief for LTCHs, Sec. 15006. Extension of certain LTCH Medicare payment rules, and Sec. 15007. Application of rules on the calculation of hospital length of stay to all LTCHs) HR 1628 - American Health Care Act (AHCA) of 2017, Title I, Subtitle B: Medicaid Program Enhancement HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections)

Client expense: $410,000 · Firm income: Not reported

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

Medicare Post-Acute Care Value-Based Purchasing Act, HR 3298, proposal to tie provider payment to performance

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE