Meaningful Use Hardship Relief Act of 2015

S. 2511, Improving Health Information Technology Act H.R. 836, The Health Care Safety Net Enhancement Act H.R. 865, The Good Samaritan Health Professional Act H.R.3018, The Code-FLEX Act of 2015 H.R.836, Health Care Safety Net Enhancement Act of 2015 H.R.1151, USPSTF Transparency and Accountability Act of 2015 S.1148, Resident Physician Shortage Reduction Act of 2015 H.R.2124, Resident Physician Shortage Reduction Act of 2015 S.1073, Stopping Improper Payments to Deceased People Act H.R.2003, Stopping Improper Payments to Deceased People Act H.R.1733, Fair Play Fair Pay Act of 2015 H.R. 3940, Meaningful Use Hardship Relief Act of 2015 S. 2248, Congenital Heart Futures Reauthorization Act of 2015 H.R. 3952, Congenital Heart Futures Reauthorization Act of 2015 H.R. 5263/S. 2941, Women and Lung Cancer Research and Preventive Services Act of 2016 Medicare Access and CHIP Reauthorization Act of 2015 Implementation, Medicare Physician Payment Reform, MEDPAC, surgical global payments, 21st Century Cures, Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Patient Centered Outcomes Research Institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ, USPSTF, Graduate Medical Education, Electronic cigarette regulation, Physician-Focused Payment Model Technical Advisory Committee (PTAC), Trans Pacific Partnership, Proposed Medical Device Surveillance System, Meaningful Use, Congenital Heart Disease Funding, Unique Device Identifiers, Hospital Outpatient Prospective Payment System, Medicare Physician Fee Schedule

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Radiation oncology reimbursement. Radiation oncology treatment safety. In office ancillary service exception for Stark laws. H.R.3940, To amend title XVIII of the Social Security Act to authorize a blanket meaningful use significant hardship exception for the 2015 reporting period due to the delay in timely publication of the Stage 2 meaningful use rule. S.1549, To amend title XVIII of the Social Security Act to provide for advanced illness care coordination services for Medicare beneficiaries, and for other purposes. H.R. 6, 21st Century Cures Act.

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

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

Advocate regarding proposed regulations under Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage and health insurance exchange networks (S. 2392 / H.R. 4227, the Medicare Advantage Bill of Rights Act of 2015). Support legislation to eliminate the Independent Payment Advisory Board (S.141/ H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015). Lobby Congress on improvements to Health Information Technology implementation. Lobby Congress on issues related to telemedicine and Medicare reimbursement. Support legislation to have telemedicine services reimbursable by Medicare (S. 2484/ H.R. 4442, the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act). Advocate on use and availability of health care data. Lobby in support of legislation to provide more flexibility in the Meaningful Use program (, H.R. 3309, the Further Flexibility in HIT Reporting and Advancing Interoperability (Flex IT 2) Act), H.R. 3940, HR 5001/S.2822 Flexibility in Electronic Health Record Reporting Act. Advocate for EHR interoperability and enhancements to the federal certification system for health information technology (S. 2141, Transparent Ratings on Usability & Security to Transform Technology Act of 2015 and S.2511, Improving Health Information Technology Act). Lobby in support of legislation to require the Secretary of Health and Human Services to issue guidance on the application of the Common Rule to clinical data registries (H.R. 965, Facilitating Participation in Clinical Data Registries Act of 2015). Support legislation to reduce Medicare fraud and improve access to Death Master File, S. 1073, the Stopping Improper Payments to Deceased People Act. Advocate for improving disease management and care coordination for patients with chronic diseases Support preservation of the In Offices Ancillary Services Exemption under Stark Law regarding physician self-referral. Advocate against H.R. 5008, Promoting Integrity in Medicare Act of 2016 Support legislation to provide more flexibility in compliance with the Sunshine Act (S.2978). Advocate against data blocking by Electronic Health Records vendors. Support legislation to have telemedicine services reimbursable by Medicare (S. 2484/H.R. 4442, the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act). Support S. 2978, Protecting Continuing Physician Education & Patient Care Act. Advocate for increased graduate medical education funding. Lobby members of House to write to CMS in opposition of a policy in the 2017 Medicare Physician Fee Schedule Proposed Rule that would require all physicians to collect and report data on all services included in 10- and 90-day global surgery codes.

Client expense: $470,000 · Firm income: Not reported

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

S. 2511, Improving Health Information Technology Act H.R. 836, The Health Care Safety Net Enhancement Act H.R. 865, The Good Samaritan Health Professional Act H.R.3018, The Code-FLEX Act of 2015 H.R.836, Health Care Safety Net Enhancement Act of 2015 H.R.1151, USPSTF Transparency and Accountability Act of 2015 S.1148, Resident Physician Shortage Reduction Act of 2015 H.R.2124, Resident Physician Shortage Reduction Act of 2015 S.1073, Stopping Improper Payments to Deceased People Act H.R.2003, Stopping Improper Payments to Deceased People Act H.R.1733, Fair Play Fair Pay Act of 2015 H.R. 3940, Meaningful Use Hardship Relief Act of 2015 S. 2248, Congenital Heart Futures Reauthorization Act of 2015 H.R. 3952, Congenital Heart Futures Reauthorization Act of 2015 H.R. 5263/S. 2941, Women and Lung Cancer Research and Preventive Services Act of 2016 Medicare Access and CHIP Reauthorization Act of 2015 Implementation, Medicare Physician Payment Reform, MEDPAC, surgical global payments, 21st Century Cures, Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Patient Centered Outcomes Research Institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ, USPSTF, Graduate Medical Education, Electronic cigarette regulation, Physician-Focused Payment Model Technical Advisory Committee (PTAC), Trans Pacific Partnership, Proposed Medical Device Surveillance System, Meaningful Use, Congenital Heart Disease Funding, Unique Device Identifiers, Hospital Outpatient Prospective Payment System, Medicare Physician Fee Schedule

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

In Office Ancillary Services: Protect Stark law exception to allow timely access to quality medical services. Support HR 3940, Meaningful Use Hardship Relief Act of 2015, which provided physicians with a hardship exemption to Stage 2 meaningful use regulations Ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Track ICD 10 implementation Track implementation of MACRA (Medicare Access and CHIP Reauthorization Act) Support HR 3014: Medical Controlled Substances Transportation Act of 2015: This bill amends the Controlled Substances Act to allow a physician to transport controlled substances to another practice setting or disaster area if the physician is registered to dispense, or conduct research with, controlled substances listed on schedules II, III, IV, or V, and the physician enters into a specific agreement with the Drug Enforcement Administration (DEA).

Client expense: $268,918 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Radiation oncology reimbursement. Radiation oncology treatment safety. In office ancillary service exception for Stark laws. H.R.3940, To amend title XVIII of the Social Security Act to authorize a blanket meaningful use significant hardship exception for the 2015 reporting period due to the delay in timely publication of the Stage 2 meaningful use rule. S.1549, To amend title XVIII of the Social Security Act to provide for advanced illness care coordination services for Medicare beneficiaries, and for other purposes. Cancer Moonshot Initiative.

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

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

H.R. 3940 -- Bill that would authorize a blanket Medicare Electronic Health Record Meaningful Use hardship exemption for the 2015 reporting period.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2511, Improving Health Information Technology Act H.R. 836, The Health Care Safety Net Enhancement Act H.R. 865, The Good Samaritan Health Professional Act H.R.3018, The Code-FLEX Act of 2015 H.R.836, Health Care Safety Net Enhancement Act of 2015 H.R.1151, USPSTF Transparency and Accountability Act of 2015 S.1148, Resident Physician Shortage Reduction Act of 2015 H.R.2124, Resident Physician Shortage Reduction Act of 2015 S.1073, Stopping Improper Payments to Deceased People Act H.R.2003, Stopping Improper Payments to Deceased People Act H.R.1733, Fair Play Fair Pay Act of 2015 H.R. 3940, Meaningful Use Hardship Relief Act of 2015 S. 2248, Congenital Heart Futures Reauthorization Act of 2015 H.R. 3952, Congenital Heart Futures Reauthorization Act of 2015 H.R. 5263/S. 2941, Women and Lung Cancer Research and Preventive Services Act of 2016 Medicare Access and CHIP Reauthorization Act of 2015 Implementation, Medicare Physician Payment Reform, MEDPAC, surgical global payments, 21st Century Cures, Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Patient Centered Outcomes Research Institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ, USPSTF, Graduate Medical Education, Electronic cigarette regulation, Physician-Focused Payment Model Technical Advisory Committee (PTAC), Trans Pacific Partnership, Proposed Medical Device Surveillance System, Meaningful Use, Congenital Heart Disease Funding, Unique Device Identifiers

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Advocate regarding proposed regulations under Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage and health insurance exchange networks (S. 2392 / H.R. 4227, the Medicare Advantage Bill of Rights Act of 2015). Support legislation to eliminate the Independent Payment Advisory Board (S.141/ H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015). Lobby Congress on improvements to Health Information Technology implementation. Lobby Congress on issues related to telemedicine and Medicare reimbursement. Advocate on use and availability of health care data. Lobby in support of legislation to provide more flexibility in the Meaningful Use program (, H.R. 3309, the Further Flexibility in HIT Reporting and Advancing Interoperability (Flex IT 2) Act), H.R. 3940, HR 5001/S.2822 Flexibility in Electronic Health Record Reporting Act. Advocate for EHR interoperability and enhancements to the federal certification system for health information technology (S. 2141, Transparent Ratings on Usability & Security to Transform Technology Act of 2015 and S.2511, Improving Health Information Technology Act). Lobby in support of legislation to require the Secretary of Health and Human Services to issue guidance on the application of the Common Rule to clinical data registries (H.R. 965, Facilitating Participation in Clinical Data Registries Act of 2015). Support legislation to improve transparency and due process in the Medicare RAC audit and appeals process (H.R. 2568, Fair Medical Audits Act). Support legislation to reduce Medicare fraud and improve access to Death Master File, S. 1073, the Stopping Improper Payments to Deceased People Act. Advocate for improving disease management and care coordination for patients with chronic diseases Support preservation of the In Offices Ancillary Services Exemption under Stark Law regarding physician self-referral. Advocate against H.R. 5008, Promoting Integrity in Medicare Act of 2016 Support legislation to provide more flexibility in compliance with the Sunshine Act (S.2978). Advocate against data blocking by Electronic Health Records vendors. Support legislation to have telemedicine services reimbursable by Medicare (S. 2484/ H.R. 4442, the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act). Support S. 2978, Protecting Continuing Physician Education & Patient Care Act. Advocate for increased graduate medical education funding.

Client expense: $400,000 · Firm income: Not reported

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

In Office Ancillary Services: Protect Stark law exception to allow timely access to quality medical services. Support HR 3940, Meaningful Use Hardship Relief Act of 2015, which provided physicians with a hardship exemption to Stage 2 meaningful use regulations Ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Track ICD 10 implementation Track implementation of MACRA (Medicare Access and CHIP Reauthorization Act) Support HR 3014: Medical Controlled Substances Transportation Act of 2015: This bill amends the Controlled Substances Act to allow a physician to transport controlled substances to another practice setting or disaster area if the physician is registered to dispense, or conduct research with, controlled substances listed on schedules II, III, IV, or V, and the physician enters into a specific agreement with the Drug Enforcement Administration (DEA).

Client expense: $508,077 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

H.R. 1707, Access to Frontline Health Care Act, all sections H.R. 1741, Truth in Health Marketing Act, all sections H.R. 1190, Protecting Seniors Access to Medicare Act, all sections S. 141, Protecting Seniors Access to Medicare Act, all sections P.L. 111-192, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, all sections related to physicians and vision P.L. 111-148 Affordable Care Act, modifications: 1. Reducing regulatory/costly burdens on medical practices - relief from regulatory penalties 2. Preserving patient access to office ancillary testing services 3. Essential Benefits - Children's Vision 4. Independent Payment Advisory Board H.R. 1312, National Health Service Corps Improvement Act Meaningful Use/EHR program issues P.L. 113-54, Drug Quality & Security Act, all sections Protecting Access to Medicare Act (P.L. 113-93) ASC Quality Reporting Program Medicare Advantage plan network adequacy H.R. 270, FlexIT Act, all sections H.R. 3309, Flex IT 2 Act, all sections H.R. 3940, Meaningful Use Hardship Relief Act S. 2141, Trust IT Act 2016 Physician Schedule Rule, sections pertaining to fee cuts Drug Price Increases Medicare Part B Drug Demonstration Medicare Access and CHIP Reauthorization Act (PL114-10) S.2777, Contact Lens Consumer Health Protection Act H.R. 6, 21st Century Cures

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Radiation oncology reimbursement. Radiation oncology treatment safety. In office ancillary service exception for Stark laws. H.R.3940, To amend title XVIII of the Social Security Act to authorize a blanket meaningful use significant hardship exception for the 2015 reporting period due to the delay in timely publication of the Stage 2 meaningful use rule. S.1549, To amend title XVIII of the Social Security Act to provide for advanced illness care coordination services for Medicare beneficiaries, and for other purposes. Cancer Moonshot Initiative.

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

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

H.R. 3940 -- Bill that would authorize a blanket Medicare Electronic Health Record Meaningful Use hardship exemption for the 2015 reporting period. Implementation of the appropriation use criteria program under Medicare for advanced diagnostic imaging

Client expense: Not reported · Firm income: $21,000

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

In-Office Ancillary Services: Protect Stark law exception to allow timely access to quality medical services; Ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Improve the quality of musculoskeletal care; Quality measurement; ICD-10; Supported HR 3940 which provided physicians with a hardship exemption to Stage 2 meaningful use regulations.

Client expense: $347,093 · Firm income: Not reported

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

S. 2511, Improving Health Information Technology Act H.R. 836, The Health Care Safety Net Enhancement Act H.R. 865, The Good Samaritan Health Professional Act H.R.3018, The Code-FLEX Act of 2015 H.R.836, Health Care Safety Net Enhancement Act of 2015 H.R.1151, USPSTF Transparency and Accountability Act of 2015 S.1148, Resident Physician Shortage Reduction Act of 2015 H.R.2124, Resident Physician Shortage Reduction Act of 2015 S.1073, Stopping Improper Payments to Deceased People Act H.R.2003, Stopping Improper Payments to Deceased People Act H.R.1733, Fair Play Fair Pay Act of 2015 H.R. 3940, Meaningful Use Hardship Relief Act of 2015 S. 2248, Congenital Heart Futures Reauthorization Act of 2015 H.R. 3952, Congenital Heart Futures Reauthorization Act of 2015 Medicare Access and CHIP Reauthorization Act of 2015 Implementation, Medicare Physician Payment Reform, MEDPAC, surgical global payments, 21st Century Cures, Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Patient Centered Outcomes Research Institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ, USPSTF, Graduate Medical Education, Electronic cigarette regulation, Physician-Focused Payment Model Technical Advisory Committee (PTAC), Trans Pacific Partnership, Proposed Medical Device Surveillance System, Meaningful Use, Congenital Heart Disease Funding, Unique Device Identifiers

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Policies related to graduate medical education and payment for primary care including S. 737, Ensuring Access to Primary Care for Women & Children Act; general education around primary care issues including Congressional Primary Care Caucus; implementation of physician payment policy within H.R. 2, the Medicare Access and CHIP Reauthorization Act; and issues related to the meaningful use electronic health record program including S. 2425, the Patient Access and Medicare Protection Act, H.R. 3940 Meaningful Use Hardship Relief Act of 2015, H.R. 4273/S. 2409 Medicare and Medicaid Improvements and Adjustments Act of 2015 and H.R. 2029, Consolidated Appropriations Act of 2016; policies related to addressing mental health; and policies related to opioid abuse.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Policies related to graduate medical education and payment for primary care including S. 737, Ensuring Access to Primary Care for Women & Children Act; general education around primary care issues including Congressional Primary Care Caucus; implementation of physician payment policy within H.R. 2, the Medicare Access and CHIP Reauthorization Act; and issues related to the meaningful use electronic health record program including S. 2425, the Patient Access and Medicare Protection Act, H.R. 3940 Meaningful Use Hardship Relief Act of 2015, H.R. 4273/S. 2409 Medicare and Medicaid Improvements and Adjustments Act of 2015 and H.R. 2029, Consolidated Appropriations Act of 2016; policies related to addressing mental health; and policies related to opioid abuse.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Radiation oncology reimbursement. Radiation oncology treatment safety. In office ancillary service exception for Stark laws. H.R.3940, To amend title XVIII of the Social Security Act to authorize a blanket meaningful use significant hardship exception for the 2015 reporting period due to the delay in timely publication of the Stage 2 meaningful use rule. S.1549, To amend title XVIII of the Social Security Act to provide for advanced illness care coordination services for Medicare beneficiaries, and for other purposes.

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

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

Optometric Equity in Medicaid Act, Federal mandates for Medicaid of optometric medical & surgical coverage, all sections SGR - Medicare Physician Payment Reform H.R. 1707, Access to Frontline Health Care Act, all sections H.R. 1741, Truth in Health Marketing Act, all sections H.R. 1190, Protecting Seniors Access to Medicare Act, all sections S. 141, Protecting Seniors Access to Medicare Act, all sections P.L. 111-192, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, all sections related to physicians and vision P.L. 111-148 Affordable Care Act, modifications: 1. Reducing regulatory/costly burdens on medical practices - relief from regulatory penalties 2. Preserving patient access to office ancillary testing services 3. Essential Benefits - Children's Vision 4. Independent Payment Advisory Board H.R. 1312, National Health Service Corps Improvement Act Meaningful Use/EHR program issues P.L. 113-54, Drug Quality & Security Act, all sections Protecting Access to Medicare Act (P.L. 113-93) ASC Quality Reporting Program Medicare Advantage plan network adequacy H.R. 270, FlexIT Act, all sections H.R. 3309, Flex IT 2 Act, all sections H.R. 3940, Meaningful Use Hardship Relief Act S. 2141, Trust IT Act 2016 Physician Schedule Rule, sections pertaining to fee cuts Drug Price Increases Medicare Part B Drug Demonstration

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

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

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

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

Meaningful Use Hardship Relief Act of 2015 (HR 3940)

Client expense: $23,509 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

In-Office Ancillary Services: Protect Stark law exception to allow timely access to quality medical services; Ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Improve the quality of musculoskeletal care; Quality measurement; ICD-10; Supported HR 3940 which provided physicians with a hardship exemption to Stage 2 meaningful use regulations.

Client expense: $494,459 · Firm income: Not reported

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

Supported HR 3940 which provided physicians with a hardship exemption to Stage 2, meaningful use regulations. Supported HR 921, medical liability legislation, which provides liability protection to team physicians who travel across state lines with a team.

Client expense: $54,397 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, all provisions S. 141, Protecting Seniors' Access to Medicare Act of 2015, all provisions H.R. 2102, Medicare Diabetes Prevention Act of 2015, all provisions S. 1131, Medicare Diabetes Prevention Act of 2015, all provisions H.R. 169, Critical Access Hospital Relief Act of 2015, all provisions S. 258, Critical Access Hospital Relief Act of 2015, all provisions H.R. 2513, Promoting Access, Competition, and Equity (PACE) Act of 2015, all provisions S. 2153, Provider Payment Sunshine Act, all provisions S. 2425, Patient Access and Medicare Protection Act, all provisions H.R. 270, Flexibility in Health IT Reporting (Flex-IT) Act of 2015, all provisions H.R. 3309, Flex-IT 2 Act, all provisions H.R. 976, Patient Access to Higher Quality Health Care Act of 2015, all provisions H.R. 1018, Patient Access to Disposable Medical Technology Act of 2015, all provisions H.R. 2568, Fair Medical Audits Act of 2015, all provisions H.R. 169, Critical Access Hospital Relief Act of 2015, all provisions H.R. 3940, Meaningful Use Hardship Relief Act of 2015, all provisions S. 2141, Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015, all provisions S. 2368, Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015, all provisions H.R. 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, all provisions S. 810, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, all provisions H. R.2 - Medicare Access and CHIP Reauthorization Act of 2015, all provisions S. 843, Improving Access to Medicare Coverage Act of 2015, all provisions H.R. 3770, End Surprise Billing Act of 2015, all provisions Medicare program: Protecting Access to Medicare Act (PAMA) implementation Medicare program: MACRA Implementation/Alternate payment models Medicare program: ACA implementation/Marketplace open enrollment Medicare program: Independent Payment Advisory Board Repeal (IPAB) Medicare program: Misvalued Codes Medicare program: Meaningful Use Regulations/Electronic Health Records Medicare program: Electronic Health Records (EHR) interoperability and certification Medicare program: Telehealth and Medicare coverage Medicare program: Sequestration Medicare program: Comprehensive Joint Replacement Initiative Medicare program: In-Office Ancillary Services Exception (IOASE) Medicare program: Merit-Based Incentive Payment System (MIPS) Medicare program: Value-Based Payment Modifier (VPM) Medicare program: Graduate Medical Education (GME) Medicare program: Meaningful Use/hardship exemptions and Stage 3 regulations Medicare program: Prescription Drug Diversion Medicare program: Physician data Medicare program: Clinical Diagnostic Laboratory Tests Payment System Medicare program: Physician Quality Reporting System (PQRS) Medicare program: Drugs of Abuse Testing Medicare program: Program Integrity Medicare program: Recovery Audit Contracting (RAC) Medicare program: Mental health and HIPAA privacy law Medicare program: Chronic care Medicare program: Medicare Advantage/narrow networks Medicare program: Pre-diabetes Medicare program: Hypertension Medicare program: Drug pricing Medicare program: Relative Value Scale Update Committee (RUC) Medicaid program: Medicaid expansion Medicaid program: CPT Medicare and Medicaid programs: ICD-10

Client expense: $4,530,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R. 3537, Synthetic Drug Control Act of 2015, all provisions H.R. 3940, Meaningful Use Hardship Relief Act of 2015, all provisions H.R. 1270, Restoring Access to Medication Act of 2015, all provisions S. 709, Restoring Access to Medication Act of 2015, all provisions H.R. 270, Flexibility in Health IT Reporting (Flex-IT) Act of 2015, all provisions H.R. 3309, Flex-IT 2 Act, all provisions S. 2141, Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015, all provisions H.R. 3520, Pulmonary Hypertension Research and Diagnosis Act of 2015, all provisions H.R. 1936, Improving the Integrity of Disability Evidence Act, all provisions S. 1945, Mental Health Reform Act of 2015, all provisions H.R. 2646, Helping Families in Mental Health Crisis Act of 2015, all provisions 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, all provisions H.R.6, 21st Century Cures Act, all provisions H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015, all provisions H.R. 3770, End Surprise Billing Act of 2015, all provisions Radiation Oncology Therapy Coding Medical Licensure - The Interstate Medical Licensure Compact Prescription Drug Diversion and Abuse Physician Owned Hospitals Health Savings Accounts - Prescription requirements for over-the-counter medications Opioid Abuse Telemedicine Drug Pricing Electronic Health Records (EHR) interoperability and certification Meaningful Use/hardship exemptions and Stage 3 regulations Precision Medicine Cybersecurity Sunshine Act FDA/NIH Modernization Laboratory Developed Tests (LDT) Mental health and HIPAA privacy law HIPAA Chronic care Child-resistant packaging for energy drinks COBRA grace period Dietary guidelines ICD-10 Antibiotic resistance Pre-diabetes Hypertension Homelessness - impact on health XR-29-2013 related penalty/12 month delay Clinical Laboratory Improvement Amendments (CLIA)/oversight modernization

Client expense: $4,530,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, health insurance market reforms, delivery system reforms, health care financing options, physician antitrust and malpractice issues, health information technology, prevention and wellness issues, comparative effectiveness research. Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments, health insurance market reforms, delivery system reforms, health care financing options, physician antitrust and malpractice issues, health information technology, prevention and wellness issues, comparative effectiveness research. Quality Measure Development Public Law 113-146, Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, implementation of all provisions. H.R. 3940, Meaningful Use Hardship Relief Act of 2015, all provisions H.R. 1270, Restoring Access to Medication Act of 2015, all provisions S. 709, Restoring Access to Medication Act of 2015, all provisions H.R. 270, Flexibility in Health IT Reporting (Flex-IT) Act of 2015, all provisions H.R. 3309, Flex-IT 2 Act, all provisions H.R.6, 21st Century Cures Act, all provisions H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015, all provisions Prescription Drug Diversion and Abuse Electronic Health Records(EHR)interoperability and certification Meaningful Use/hardship exemptions and Stage 3 regulations

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

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

Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicaid program - Parity for primary care physician services Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Discussions with congressional staff on misvalued coding issues. Medicaid program - Parity for primary care physician services Public Law 114-10, the Medicare Access and CHIP Reauthorization Act - Implementation issues surrounding Medicare physician payment reform and CHIP extension. H.R. 3940, Meaningful Use Hardship Relief Act of 2015, all provisions S. 2368, Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015, all provisions Public Law 114-113, Consolidated Appropriations Act, 2016, provisions relating to Meaningful Use Medicare program. Public Law 114-74, Bipartisan Budget Act of 2015, provisions relating to Medicare and health care generally.

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

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

HR 1220 / S. 624 - Removing Barriers to Colorectal Cancer Screening Act HR 3940 - A bill authorizing a blanket Medicare Electronic Health Record Meaningful Use hardship exemption for the 2015 reporting period. S. 1347 / HR 887 -- The Electronic Health Fairness Act; A bill exempting patient encounters that occur in Ambulatory Surgery Centers when calculating attainment of the Medicare Electronic Health Record Meaningful Use requirements.

Client expense: Not reported · Firm income: $28,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3940 -- Bill that would authorize a blanket Medicare Electronic Health Record Meaningful Use hardship exemption for the 2015 reporting period.

Client expense: Not reported · Firm income: $21,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3940 - Meaningful Use Hardship Relief Act of 2015 / S. 2425 - Patient Access and Medicare Protection Act: Hardship exemptions for meaningful use of electronic health care records.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1695, HR 3020 - FY 2016 appropriations AHRQ, HRSA Title VII, NHSC: AAFP Federal spending priorities to support workforce, research. HR 1314 - Bipartisan Budget Act/Budget Control Act relief to end sequestration for non-defense discretionary spending: Funding for AAFP priorities; mitigating budget increases for medicare part B enrollees. HR 2029 - Funding of primary care and quality research at Agency for Healthcare Research and Quality: Primary care research at AHRQ. HR 3020 - Oppose House draft FY16 bill to eliminate AHRQ: Preserve primary care practice-based research, patient safety, HIT. HR 3940 - Meaningful use 2 hardship relief: Prevent penalty on FPs who have not met MU2. No Bill No.- HHS Budget planning for FY 16 & 17: Funding for AAFP Priorities No Bill No.- Congressional Primary Care Caucus: Primary care to achieve triple aim in health care. No Bill No. - National Advisory Council on National Health Service Care (NHSC): Primary care physician workforce and medical student debt relief. No Bill No. - Congressional Public Health Caucus Briefing: AAFP federal spending priorities. No Bill No. - National Coalition on Health Care forum on Advanced Medical Home: primary care practice model. No Bill No. - Attend weekly legislative strategy meetings: Support of Legislative efforts to advance primary care policies through insurance reform, public health, graduate medical education and regulatory flexibility.

Client expense: $875,940 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Administration, Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 938, S 1299, S2151 - NHSC provisions in mental health reform. Primary care physician workforce. HR 3020 - Oppose House draft FY 16 bill to eliminate AHRQ: Primary care practice-based research, patient safety, HIT.: Prevent penalty on FPs who have not met MU2. HR 3940 - Meaningful Use 2 hardship relief: granting CMS authority to use blanket hardship exemptions for MU2 penalties. S. 1695, HR 3020, HR 2029 - FY 2016 appropriations AHRQ, HRSA Title VII, NHSC: AAFP Federal spending priorities to support workforce, research. HR 1314 - Bipartisan Budget Act/Budget Control Act relief to end sequestration for non-defense discretionary spending: Funding for AAFP priorities; mitigating budget increases for medicare part B enrollees. HR 2017 - Common Sense Nutrition disclosure act: Supporting current FDA policy on menu labeling. HR 2029 - Consolidated appropriations act: Permitting CDC to conduct research on gun violence. HR 2029 - Funding of primary care and quality research at Agency for Healthcare Research and Quality HR 2058 FDA Deeming Clarification Act: Opposing the exemption of e-cigarettes and cigars from premarket review by the FDA. HR 2646 - Helping Families in Mental Health Crisis Act: Integrating Primary Care and mental health. HR 3242 - Child Nicotine Poisoning Prevention Act: Authorizing consumer product safety commission to require child resistant packaging for liquid nicotine. HR 3940 Meaningful Use Hardship Relief Act: Granting CMS authority to use blannket hardship exemptions for Meaningful Use stage 2 penalties. HR 4234 - Primary Care Physician Reentry Act: Support family physicians wishing to re-enter practice. S. 1719 - Recognize, Assist, Include, Support and Engate (RAISE) Family Caregivers Act: Establishing a national strategy to support family caregivers. S. 1945 - Mental Health reform Act: Integrating primary Care and mental health. No Bill No. - Chronic Care Management: advocate for introduction of bill to eliminate the Part B coinsurance. No Bill No.- Health IT: Lobby to raise awareness of hardships created by implementation of Meaningful Use program; advocate for a pause on Stage 3, etc. No Bill No.-Graduate Medical Education: Advocate for introduction of a bill to require CMS to report data on residency positions; raise awareness and advocate for AAFP's policy proposals on GME; advocate for introduction of a bill to help fix a suite of issues predominantly impacting rural health (e.g. rotators problem); advocate for improvement of the VA GME framework to better accommodate family medicine. No Bill No.- Physician Payment Reform: MACRA implementation questions/conversations. No Bill No. - Internal Revenue Code: Advocate for US tax law to allow people with HSAs to contract with physicians outside of insurance (which will allow physicians practicing with direct primary care to have more access to patients). No Bill No. - HHS budget planning for FY 16&17: funding for AAFP priorities. No Bill No. - Congressional Primary Care Caucus: Primary care to achieve the triple aim in health care; Launching the caucus. No Bill No. - Teaching Health Center Graduate Medical Education permanence: GME for community based family medicine residencies. No Bill No. - Meaningful Use 3 implementation pause: Align MU timeline with MACRA advanced payment models. No Bill No. - Veterans Health Administration Graduate Medical Education: Federal Support of family medicine education and training. No Bill No. - National Advisory Council on National Health Service Care (NHSC): Primary care physician workforce and medical student debt relief. No Bill No. - Congressional Public Health Caucus bfg: AAFp Federal Spending priorities. No Bill No.- HRSA Title VII technical assistance webinars: Primary Care training grants. No Bill No. - National Coalition on Advanced Medical Home: Primary care practice model. No Bill No.- AAFP initiative to address opioid abuse: Appropriate pain management preventing opioid abuse. No Bill No. - Nominate FPs to HHS HIV committee, CDC prevention committee, VA rural Health Committee, HRSA Committee: Getting FPs on federal committees. No Bill No. - MACRA implementation: Letters regarding MACRA implementation. No Bill No. - Non-discrimination in health plans: Calling for nondiscrimination in health plans and limited English proficiency requirements. No Bill No. - Tobacco Control: tobacco cessation benefits. No Bill No. - FPs ability to treat commercial truck drivers: Ability for PCPs to treat diabetes. No Bill No. - CMS on GAO RUC report: Calling on CMS to address GAO RUC report on physician payment. No Bill No. - 2017 Marketplaces: Insurance design in 2017 plans. No Bill No. - HPV Gardasill vaccine: comments on patient info. No Bill No. - 2016 final medicare fee schedule: Commented on CMS final policy changes for 2016. No Bill No. - Advance care planning: Support for advance care planning code. No Bill No. - Discharge Planning: discharge planning proposed rule. No Bill No. - Medicaid access: Medicaid access final rule. No Bill No. - Child-resistant packaging for liquid nicotine: Requiring child-resistant packaging for liquid nicotine. No Bill No. - Prescription Drug Abuse: Participating in White House forum on Prescription Drug Abuse. No Bill No. - Medicare Access and CHIP Reauthorization Act MACRA implementation: Responding to CMS RFT on implementation of MACRA payment methods. No Bill No. - Tobacco cessation clinical recommendations: Requiring comprehensive tobacco cessation benefit. No Bill No.-Health IT: Working to promote legislation for the FLEX-IT2 Act; and Meaningful Use flexibility; attend weekly coalition meetings. No Bill No. - Attend weekly legislative strategy meetings: Support of Legislative efforts to advance primary care policies through insurance reform, public health, graduate medical education and regulatory flexibility. No Bill No. - Legislative strategy: Promoting legislative efforts to advance primary care policies. No Bill No. - Public health coalition meeting: Advancing the integration of public health and primary care through access to mental health, injury prevention and other policies. No Bill No. - Attend Adult Vaccine monthly coalition meetings; hearing questions. No Bill No. - Primary care issues: Meaningful Use, MACRA, Mental Health. No Bill No. - Mental Health reform; preparing materials, briefing AAFP leaders , participating in coalition meetings and calls: Promoting primary care physicians' role in improving mental health. No Bill No. - Mental health/Substance Abuse: Educating policymakers about the AAFP;s views on substance abuse and mental health issues. No Bill No. - Chronic Care Management: advocate for introduction of bill to eliminate the Part B coinsurance. No Bill No. - Health Insurance Marketplace Issues and Provider Involvement with Patient Enrollment: Network adequacy, patient enrollment in marketplaces. No Bill No. - Children's Health Insurance: CHIP Program. No Bill No. - Health Market Consolidation.

Client expense: $875,940 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Administration, Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3940 - Meaningful Use 2 hardship relief: granting CMS authority to use blanket hardship exemptions for MU2 penalties.

Client expense: $875,940 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Administration, Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA)

In-Office Ancillary Services: Protect Stark law exception to allow timely access to quality medical services; Ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Improve the quality of musculoskeletal care; Quality measurement; ICD-10; Supported HR 3940 which provided physicians with a hardship exemption to Stage 2 meaningful use regulations.

Client expense: $674,150 · Firm income: Not reported

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

Supported HR 3940 which provided physicians with a hardship exemption to Stage 2, meaningful use regulations. Supported HR 921, medical liability legislation, which provides liability protection to team physicians who travel across state lines with a team.

Client expense: $47,004 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to Opioid abuse. Meaningful use implementation. S.2425 - Patient Access and Medicare Protection Act. H.R.3940 - Meaningful Use Hardship Relief Act of 2015.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Policies related to graduate medical education and payment for primary care including S. 737, Ensuring Access to Primary Care for Women & Children Act; general education around primary care issues including congressional primary caucus; implementation of physician payment policy within H.R. 2, the Medicare Access and CHIP Reauthorization Act; and issues related to the meaningful use electronic health record program including S. 2425, the Patient Access and Medicare Protection Act, H.R. 3940 Meaningful Use Hardship Relief Act of 2015, H.R. 4273/S. 2409 Medicare and Medicaid Improvements and Adjustments Act of 2015 and H.R. 2029, Consolidated Appropriations Act of 2016.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Optometric Equity in Medicaid Act, Federal mandates for Medicaid of optometric medical & surgical coverage, all sections SGR - Medicare Physician Payment Reform H.R. 1707, Access to Frontline Health Care Act, all sections H.R. 1741, Truth in Health Marketing Act, all sections H.R. 1190, Protecting Seniors Access to Medicare Act, all sections S. 141, Protecting Seniors Access to Medicare Act, all sections P.L. 111-192, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, all sections related to physicians and vision P.L. 111-148 Affordable Care Act, modifications: 1. Reducing regulatory/costly burdens on medical practices - relief from regulatory penalties 2. Preserving patient access to office ancillary testing services 3. Essential Benefits - Children's Vision 4. Independent Payment Advisory Board H.R. 1312, National Health Service Corps Improvement Act Meaningful Use/EHR program issues P.L. 113-54, Drug Quality & Security Act, all sections H.R. 2, Medicare Access & CHIP Reauthorization Act Protecting Access to Medicare Act (P.L. 113-93) ASC Quality Reporting Program Medicare Advantage plan network adequacy 2015 Physician Schedule Rule, Issues pertaining to clinical data regional/global surgery payments H.R. 270, FlexIT Act, all sections H.R. 3309, Flex IT 2 Act, all sections H.R. 3940, Meaningful Use Hardship Relief Act S. 2141, Trust IT Act 2016 Physician Schedule Rule, sections pertaining to fee cuts Drug Price Increases

Client expense: $160,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare physician payment; new/alternative payment models; global surgical payment; Medicare coverage; Medicare hospital payment, including Ways & Means Committee hospital payment project; physician and hospital quality; medical liability reform; electronic health record incentive program and the FLEX-IT Act; HR 3309, FLEX-IT 2 Act; clinical data registries; graduate medical education; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Promoting Integrity in Medicare Act; HR 2, the Medicare Access and CHIP Reauthorization Act of 2015; HR 1470, the SGR Repeal and Medicare Provider Payment Modernization Act of 2015; S 488/HR 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. 298/H.R. 546, The Advancing Care for Exceptional Kids Act of 2015, a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; H.R. 2124/S. 1148, the Resident Physician Shortage Reduction Act; ICD-10 transition; end of life care; HR 3940, the Meaningful Use Hardship Relief Act, and S 2425, which provides for hardship exceptions for the 2015 Meaningful Use reporting period.

Client expense: $750,000 · 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), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015 S. 810, SGR Repeal and Medicare Provider Payment Modernization Act of 2015 H.R. 836, The Health Care Safety Net Enhancement Act H.R. 865, The Good Samaritan Health Professional Act H.R.3018, The Code-FLEX Act of 2015 H.R.836, Health Care Safety Net Enhancement Act of 2015 H.R.1151, USPSTF Transparency and Accountability Act of 2015 S.1148, Resident Physician Shortage Reduction Act of 2015 H.R.2124, Resident Physician Shortage Reduction Act of 2015 S.1073, Stopping Improper Payments to Deceased People Act H.R.2003, Stopping Improper Payments to Deceased People Act H.R.1733, Fair Play Fair Pay Act of 2015 H.R. 3940, Meaningful Use Hardship Relief Act of 2015 S. 2248, Congenital Heart Futures Reauthorization Act of 2015 H.R. 3952, Congenital Heart Futures Reauthorization Act of 2015 H.R. 2029, Consolidated Appropriations Act Sustainable Growth Rate, Medicare Physician Payment Reform, MEDPAC, surgical global payments, 21st Century Cures, Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Patient Centered Outcomes Research Institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ, USPSTF, Graduate Medical Education, Electronic cigarette regulation, Physician-Focused Payment Model Technical Advisory Committee (PTAC), Trans Pacific Partnership, Proposed Medical Device Surveillance System, Meaningful Use, Congenital Heart Disease Funding, Unique Device Identifiers,

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Two Midnight Rule Socioeconomic adjustment of the hospital readmission reduction program (H.R. 1343/ S. 688) Medicare audit contractor program reforms (H.R. 2156, AFIRM Act) Health information technology (H.R. 270, H.R. 3309, H.R. 3940, S. 2425) Medicare Access and CHIP Reauthorization Act (H.R. 2) Patient status notification (H.R. 876, S. 1349) Rural hospital policies (H.R. 663 / S. 332, H.R. 169 / S. 258, H.R. 1611 / S. 257, S. 1461 / H.R. 2878) Telehealth, interoperability (H.R. 6) Physician self-referral (H.R. 2027, H.R. 976) Hospital Improvements for Payment Act (H.R. 3291) Post-Acute Care policies (H.R. 1458, H.R. 3298) Graduate Medical Education policy reforms (H.R. 2124, S. 1148, H.R 3292) DSH payment (H.R. 3288) Bipartisan Budget Act (H.R. 1314) Clinical lab payment policy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage and health insurance exchange networks (S. 2392 / H.R. 4227, the Medicare Advantage Bill of Rights Act of 2015). Support legislation to eliminate the Independent Payment Advisory Board (S.141/ H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015). Advocate on issues related to waste, fraud and abuse in Medicare Advocate for increased funding and reforms to Graduate Medical Education. Lobby Congress on improvements to Health Information Technology implementation. Lobby Congress in opposition to repeal of the in-office ancillary and physician services exception for anatomic pathology services. Lobby Congress on issues related to telemedicine and Medicare reimbursement. Advocate on use and availability of health care data. Lobby in support of legislation to provide more flexibility in the Meaningful Use program and extend the 90 day reporting period for demonstration meaningful use in 2015 (H.R. 270, Flexibility in Health IT Reporting (Flex-IT) Act, H.R. 3309, the Further Flexibility in HIT Reporting and Advancing Interoperability (Flex IT 2) Act), H.R. 3940, the Meaningful Use Hardship Relief Act of 2015 and S. 2425, Patient Access and Medicare Protection Act. Advocate for EHR interoperability and enhancements to the federal certification system for health information technology (S. 2141, Transparent Ratings on Usability & Security to Transform Technology Act of 2015 and S. 289, the American Cures Act. Lobby in support of legislation to require the Secretary of Health and Human Services to issue guidance on the application of the Common Rule to clinical data registries (H.R. 965, Facilitating Participation in Clinical Data Registries Act of 2015). Support legislation to improve transparency and due process in the Medicare RAC audit and appeals process (H.R. 2568, Fair Medical Audits Act). Support legislation to reduce Medicare fraud and improve access to Death Master File, S. 1073, the Stopping Improper Payments to Deceased People Act.

Client expense: $280,332 · Firm income: Not reported

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

H.R. 3537, Synthetic Drug Control Act of 2015, all provisions H.R. 3940, Meaningful Use Hardship Relief Act of 2015, all provisions H.R. 1270, Restoring Access to Medication Act of 2015, all provisions S. 709, Restoring Access to Medication Act of 2015, all provisions H.R. 270, Flexibility in Health IT Reporting (Flex-IT) Act of 2015, all provisions H.R. 3309, Flex-IT 2 Act, all provisions S. 2141, Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015, all provisions H.R. 3520, Pulmonary Hypertension Research and Diagnosis Act of 2015, all provisions H.R. 1936, Improving the Integrity of Disability Evidence Act, all provisions S. 1945, Mental Health Reform Act of 2015, all provisions H.R. 2646, Helping Families in Mental Health Crisis Act of 2015, all provisions 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, all provisions H.R.6, 21st Century Cures Act, all provisions H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015, all provisions H.R. 3770, End Surprise Billing Act of 2015, all provisions Radiation Oncology Therapy Coding Medical Licensure - The Interstate Medical Licensure Compact Prescription Drug Diversion and Abuse Physician Owned Hospitals Health Savings Accounts - Prescription requirements for over-the-counter medications Opioid Abuse Telemedicine Drug Pricing Electronic Health Records (EHR) interoperability and certification Meaningful Use/hardship exemptions and Stage 3 regulations Precision Medicine Cybersecurity Sunshine Act FDA/NIH Modernization Laboratory Developed Tests (LDT) Mental health and HIPAA privacy law HIPAA Chronic care Child-resistant packaging for energy drinks COBRA grace period Dietary guidelines ICD-10 Antibiotic resistance Pre-diabetes Hypertension Homelessness - impact on health XR-29-2013 related penalty/12 month delay Clinical Laboratory Improvement Amendments (CLIA)/oversight modernization

Client expense: $4,490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, all provisions S. 141, Protecting Seniors' Access to Medicare Act of 2015, all provisions H.R. 2102, Medicare Diabetes Prevention Act of 2015, all provisions S. 1131, Medicare Diabetes Prevention Act of 2015, all provisions H.R. 169, Critical Access Hospital Relief Act of 2015, all provisions S. 258, Critical Access Hospital Relief Act of 2015, all provisions H.R. 2513, Promoting Access, Competition, and Equity (PACE) Act of 2015, all provisions S. 2153, Provider Payment Sunshine Act, all provisions S. 2425, Patient Access and Medicare Protection Act, all provisions H.R. 270, Flexibility in Health IT Reporting (Flex-IT) Act of 2015, all provisions H.R. 3309, Flex-IT 2 Act, all provisions H.R. 976, Patient Access to Higher Quality Health Care Act of 2015, all provisions H.R. 1018, Patient Access to Disposable Medical Technology Act of 2015, all provisions H.R. 2568, Fair Medical Audits Act of 2015, all provisions H.R. 169, Critical Access Hospital Relief Act of 2015, all provisions H.R. 3940, Meaningful Use Hardship Relief Act of 2015, all provisions S. 2141, Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015, all provisions S. 2368, Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015, all provisions H.R. 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, all provisions S. 810, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, all provisions H. R.2 - Medicare Access and CHIP Reauthorization Act of 2015, all provisions S. 843, Improving Access to Medicare Coverage Act of 2015, all provisions H.R. 3770, End Surprise Billing Act of 2015, all provisions Medicare program: Protecting Access to Medicare Act (PAMA) implementation Medicare program: MACRA Implementation/Alternate payment models Medicare program: ACA implementation/Marketplace open enrollment Medicare program: Independent Payment Advisory Board Repeal (IPAB) Medicare program: Misvalued Codes Medicare program: Meaningful Use Regulations/Electronic Health Records Medicare program: Electronic Health Records (EHR) interoperability and certification Medicare program: Telehealth and Medicare coverage Medicare program: Sequestration Medicare program: Comprehensive Joint Replacement Initiative Medicare program: In-Office Ancillary Services Exception (IOASE) Medicare program: Merit-Based Incentive Payment System (MIPS) Medicare program: Value-Based Payment Modifier (VPM) Medicare program: Graduate Medical Education (GME) Medicare program: Meaningful Use/hardship exemptions and Stage 3 regulations Medicare program: Prescription Drug Diversion Medicare program: Physician data Medicare program: Clinical Diagnostic Laboratory Tests Payment System Medicare program: Physician Quality Reporting System (PQRS) Medicare program: Drugs of Abuse Testing Medicare program: Program Integrity Medicare program: Recovery Audit Contracting (RAC) Medicare program: Mental health and HIPAA privacy law Medicare program: Chronic care Medicare program: Medicare Advantage/narrow networks Medicare program: Pre-diabetes Medicare program: Hypertension Medicare program: Drug pricing Medicare program: Relative Value Scale Update Committee (RUC) Medicaid program: Medicaid expansion Medicaid program: CPT Medicare and Medicaid programs: ICD-10

Client expense: $4,490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office