Enhanced Veteran Healthcare Act of 2015

Childress Institute for Pediatric Trauma Congressional Roundtable Discussion before Energy and Commerce Committee held on May 24, 2016; Labor/HHS appropriations including funding for the NIH, Agency for Healthcare Research and Quality (AHRQ) and Title VII programs; supplemental funding to respond to the Zika virus; VA-Academic affiliations work including Delivering Opportunities for Care and Services for Veterans Act, (S. 1676), Veterans Choice Improvement Act of 2016, Improving Veterans Access to Care in the Community Act, (S. 2633), Enhanced Veterans Health Care Act, (H.R. 3879); Centers for Disease Control and Preventions Guidelines for Prescribing Opioids in Chronic Pain

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

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

P.L. 114-41, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 Issue: Support improved contracting with academic affiliates and increased VA GME funding. S. 1676/H.R. 4011, Delivering Opportunities for Care and Services (DOCs) for Veterans Act H.R. 3755, To amend title XVIII of the Social Security Act to provide for the disregard of certain resident slots that include Department of Veterans Affairs training in determining payments for direct graduate medical education costs, and for other purposes. Issue: Support increased VA GME and Medicare GME funding for certain VA affiliates H.R. 3879, Enhanced Veterans Health Care Act Issue: Support VA authority for VA-academic joint ventures S. 2633, Improving Veterans Access to Care in the Community Act Issue: Support VA Plan to Consolidate Community Care Programs, including the proposed Core Network and sole source contracting with academic affiliates.

Client expense: $822,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Preparation for Childress Institute for Pediatric Trauma Congressional Roundtable Discussion before Energy and Commerce Committee scheduled for May 24, 2016; Labor/HHS FY 2017 funding in the Presidents proposed FY 2017 Budget, including funding for the Agency for Healthcare Research and Quality (AHRQ) and Title VII programs; supplemental funding to respond to the Zika virus; VA-Academic affiliations work including Delivering Opportunities for Care and Services for Veterans Act, (S. 1676), Veterans Choice Improvement Act of 2016, Improving Veterans Access to Care in the Community Act, (S. 2633), Enhanced Veterans Health Care Act, (H.R. 3879); Centers for Disease Control and Preventions Guidelines for Prescribing Opioids in Chronic Pain

Client expense: $25,000 · Firm income: Not reported

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

Preparation for Childress Institute for Pediatric Trauma Congressional Roundtable Discussion before Energy and Commerce Committee scheduled for May 24, 2016; Labor/HHS FY 2017 funding in the Presidents proposed FY 2017 Budget, including funding for the Agency for Healthcare Research and Quality (AHRQ) and Title VII programs; supplemental funding to respond to the Zika virus; VA-Academic affiliations work including Delivering Opportunities for Care and Services for Veterans Act, (S. 1676), Veterans Choice Improvement Act of 2016, Improving Veterans Access to Care in the Community Act, (S. 2633), Enhanced Veterans Health Care Act, (H.R. 3879); Centers for Disease Control and Preventions Guidelines for Prescribing Opioids in Chronic Pain

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

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

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

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

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

H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. P.L. 114-74, H.R. 1314, Bipartisan Budget Act of 2015 Issue: Oppose Medicare site-neutral payment policy. Oppose extension of Medicare sequester President's Budget, FY 2016 Issue: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform Issue: Support delay of Enforcement of new Centers for Medicare and Medicaid Services inpatient criteria (e.g., "Two-Midnight" rule) in FY 2016 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015 S. 688, Hospital Readmission Accuracy and Accountability Act Issue: Support inclusion of socioeconomic status as part of hospital readmissions program. H.R. 3288, Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act of 2015 Issue: Alter DSH payment methodology and increase DSH spending in non-Medicaid expansion states H.R. 3292, Medicare IME Pool Act of 2015 Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. H.R. 3291, Medicare Crosswalk Hospital Code Development Act of 2015 Issue: Create a crosswalk between Medicare Part A and Part B payments P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). H.R. 1117, Creating Access to Residency Education Act of 2015 Issue: Create CMS grant program for new residency programs. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program including support for adoption of National Quality Forum (NQF) recommendations. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the ACA. Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Issue: Educate congressional staff on Academic Medicine's missions including education, research, patient care, GME, workforce, and physician shortage in rural and urban communities. H.R. 2513, Promoting Access, Competition, and Equity Act of 2015 Issue: Oppose easing restrictions on physician owned hospitals Issue: Senate Finance Committee Chronic Care Workgroup, support and send comments on efforts to improve care for Medicare patients with chronic conditions. Draft Audit and Appeals Fairness, Integrity and Reforms in Medicare (AFIRM) Act of 2015 Issue: Support Medicare audit and appeal reform. S. 1676, H.R. 3755, H.R. 4011, Delivering Opportunities for Care and Services (DOCs) for Veterans Act of 2015 Issue: Support extension of VA GME increase. Support exemption of certain VA residents from Medicare GME caps. H.R. 3879, Enhanced Veterans Healthcare Act of 2015 Issue: Support joint venture authority for VA and academic affiliates Submitted comments to: -CMS on implementation of the Medicare Access and CHIP Reauthorization Act of 2015