Helping Hospitals Improve Patient Care Act of 2016

Medicare, Medicaid, NIH Funding Medical Education Funding Hospital Outpatient Department, Helping Hospital Improve Patient Care Act HR 5273, Funding FY 2016 Budget, Medicare Redesign; 340B, American Health Care Act of 2017 (AHCA); Better Care Reconciliation Act (BCRA)

Client expense: Not reported · Firm income: $48,000

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

Preventing cuts to Medicare Graduate Medical Education payments; preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); Additional Medicare support for Medicare Graduate Medical Education; Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children.

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare, Medicaid, NIH Funding Medical Education Funding Hospital Outpatient Department, Helping Hospital Improve Patient Care Act HR 5273, Funding FY 2016 Budget, Medicare Redesign; 340B, American Health Care Act of 2017 (AHCA); Better Care Reconciliation Act (BCRA)

Client expense: Not reported · Firm income: $48,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Section 218 of Pub. L. 113-93, the Protecting Access to Medicare Act; Medicare payment policies for medical imaging; site neutrality proposal in the President's Budget for Fiscal Year 2017; H.R. 2029, Consolidated Appropriations Act of 2016, Division O, Sec. 502. (Medicare Imaging Payment Provision); Implementation of Pub. L. 114-10 (MACRA), provisions impacting medical imaging; H.R. 5273 (114th Congress), Helping Hospital Improve Patient Care Act, provisions regarding site neutrality.

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

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

Preventing cuts to Medicare Graduate Medical Education payments: "The Medicare IME Pool Act of 2015" (H.R. 3292); preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); CY 2017 Medicare Hospital Outpatient Prospective payment system proposed rule: Provider reimbursements for end of life care counseling; Additional Medicare support for Medicare Graduate Medical Education; Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health service for Medicare patients: "Home Health Care Planning Improvement Act" (S 578); Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children: "Advancing Care for Exceptional Children Act of 2015" (H.R. 546/S 298).

Client expense: $70,000 · 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)

Client expense: $500,000 · 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

Section 218 of Pub. L. 113-93, the Protecting Access to Medicare Act; Medicare payment policies for medical imaging; site neutrality proposal in the President's Budget for Fiscal Year 2017; H.R. 2029, Consolidated Appropriations Act of 2016, Division O, Sec. 502. (Medicare Imaging Payment Provision); Implementation of Pub. L. 114-10 (MACRA), provisions impacting medical imaging; H.R. 5273 (114th Congress), Helping Hospital Improve Patient Care Act, provisions regarding site neutrality.

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

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

Medicare, Medicaid, NIH Funding Medical Education Funding Hospital Outpatient Department, Helping Hospital Improve Patient Care Act HR 5273, Funding FY 2016 Budget, Medicare Redesign; Two Midnight Rule; 340B, American Health Care Act of 2017 (AHCA); Better Care Reconciliation Act (BCRA)

Client expense: Not reported · Firm income: $48,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Preventing cuts to Medicare Graduate Medical Education payments: "The Medicare IME Pool Act of 2015" (H.R. 3292); preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); CY 2017 Medicare Hospital Outpatient Prospective payment system proposed rule: Provider reimbursements for end of life care counseling; Additional Medicare support for Medicare Graduate Medical Education; Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health service for Medicare patients: "Home Health Care Planning Improvement Act" (S 578); Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children: "Advancing Care for Exceptional Children Act of 2015" (H.R. 546/S 298).

Client expense: $70,000 · 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)

Client expense: $400,000 · 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

Preventing cuts to Medicare Graduate Medical Education payments: "The Medicare IME Pool Act of 2015" (H.R. 3292); preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); CY 2017 Medicare Hospital Outpatient Prospective payment system proposed rule: Provider reimbursements for end of life care counseling; Additional Medicare support for Medicare Graduate Medical Education; Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health service for Medicare patients: "Home Health Care Planning Improvement Act" (S 578); Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children: "Advancing Care for Exceptional Children Act of 2015" (H.R. 546/S 298).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated complications, healthcare associated infections, readmission, payment bundling, potentially preventable events and outcomes, and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) H.R.184 - Protect Medical Innovation Act S.108 - Medical Device Access and Innovation Protection Act H.R.2 - Medicare Access - CHIP Reauthorization Act H.R. 3422 VA Vendor Verification Act HR 1175 Health Savings Act S 403 Health Savings Act Health Savings Accounts; Flexible Spending Accounts HR 5273 Helping Hospitals Improve Patient Care Act Medicaid waiver policy Access to dental coverage H.R. 6274, The Hospital Outcomes Act Medicaid Reform American Health Care Act (AHCA) FDA User fee agreement reauthorizations (MDUFA, GDUFA)

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

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

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmissions, payment bundling, potentially preventable events,and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) H.R. 2 - Medicare Access & CHIP Reauthorization Act HR 5273 Helping Hospitals Improve Patient Care Act H.R. 6274, The Hospital Outcomes Act

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

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

Preventing cuts to Medicare Graduate Medical Education payments: "The Medicare IME Pool Act of 2015" (H.R. 3292); preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); CY 2017 Medicare Hospital Outpatient Prospective payment system proposed rule: Provider reimbursements for end of life care counseling; Additional Medicare support for Medicare Graduate Medical Education; Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health service for Medicare patients: "Home Health Care Planning Improvement Act" (S 578); Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children: "Advancing Care for Exceptional Children Act of 2015" (H.R. 546/S 298).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Section 218 of Pub. L. 113-93, the Protecting Access to Medicare Act; Medicare payment policies for medical imaging; site neutrality proposal in the President's Budget for Fiscal Year 2017; H.R. 2029, Consolidated Appropriations Act of 2016, Division O, Sec. 502. (Medicare Imaging Payment Provision); H.R. 3339/S. 1926 the Protecting Access to Lifesaving Screenings (PALS) Act re: USPSTF Breast Cancer Screening Guidelines; Implementation of Pub. L. 114-10 (MACRA), provisions impacting medical imaging; H.R. 5273, Helping Hospital Improve Patient Care Act, provisions regarding site neutrality.

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

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

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated complications, healthcare associated infections, readmission, payment bundling, potentially preventable events and outcomes, and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) H.R.184 - Protect Medical Innovation Act S.108 - Medical Device Access and Innovation Protection Act H.R.2 - Medicare Access - CHIP Reauthorization Act H.R. 3422 VA Vendor Verification Act HR 1175 Health Savings Act S 403 Health Savings Act Health Savings Accounts; Flexible Spending Accounts HR 5273 Helping Hospitals Improve Patient Care Act Medicaid waiver policy Access to dental coverage H.R. 6274, The Hospital Outcomes Act Medicaid Reform American Health Care Act (AHCA) FDA User fee agreement reauthorizations (MDUFA, GDUFA)

Client expense: $810,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmissions, payment bundling, potentially preventable events,and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) H.R. 2 - Medicare Access & CHIP Reauthorization Act HR 5273 Helping Hospitals Improve Patient Care Act H.R. 6274, The Hospital Outcomes Act

Client expense: $810,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

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

Client expense: $800,000 · 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, Medicaid, NIH Funding Medical Education Funding Hospital Outpatient Department, Helping Hospital Improve Patient Care Act HR 5273, Funding FY 2016 Budget, Medicare Redesign; Two Midnight Rule; 340B, American Health Care Act of 2017 (AHCA)

Client expense: Not reported · Firm income: $48,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health and Human Services Appropriations - In support of increased funding for the Department of Health and Human Services including National Institutes of Health research programs and Title VII and Title VIII funding; Poison Control Centers and programs for teaching and research at academic medical centers. In support of the NIH peer review system and continued support of NIH funding.In support of full restoration of NIH funding. In support of funding for National Institute for Occupational Safety and Health. In support of funding for Agency for Healthcare Research and Quality. In support of extension for 340B Program. In support of 21st Century Cures Initiative. In support of continuation of subsidized graduate student health care. In support of Centers for Medicare and Medicaid Services working with Congress to address concerns for Hospital Compare Star Ratings; in support of delay of Ratings release. In support of merger of Penn State Health and Pinnacle Health. In support of S.3056, Creating and Restoring Equal Access to Equivalent Samples Act. In support of H.R.5273, Helping Hospitals Improve Patient Care Act. In support of H.R.6088, the Hospital Quality Rating Transparency Act. In support of Sec. 603 of the Bipartisan Budget Act of 2015 re: site neutral policy. In support of authorization of center to coordinate data collection on college mental health sciences.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

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

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

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

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

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

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

H.R. 5273, the Helping Hospitals Improve Patient Care Act of 2016, issues pertaining to Medicare hospital outpatient services and reimbursements. FY 2017 Medicare Outpatient Prospective Payment System Proposed Rule, issues pertaining to hospital outpatient department status and reimbursement. P.L. 114-255, the 21st Century Cures Act, issues pertaining to Medicare hospital outpatient services and reimbursements.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate medical education Issues related to provider reimbursement H.R. 5273 - Helping Hospitals Improve Patient Care Act of 2016

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

Government targets: Energy, Dept of, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)

Utah genome project Healthcare delivery innovation Telemedicine Precision medicine Cancer research S. 2873/H.R. 5395 - Expanding Capacity for Health Outcomes Act Zika Research S. 2873 & H.R. 5395 - The ECHO Act H.R. 5273 - Helping Hospitals Improve Patient Care Act of 2016

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

Government targets: Energy, Dept of, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)

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) HR 34 - 21st Century CURES Act, Title XV - Provisions Relating 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)

Client expense: $400,000 · 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

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections,readmissions, payment bundling, potentially preventable events,and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) H.R. 2 - Medicare Access & CHIP Reauthorization Act H.R. 1470 - SGR Repeal & Medicare Provider Payment Modernization Act HR 5273 Helping Hospitals Improve Patient Care Act H.R. 6274, The Hospital Outcomes Act

Client expense: $540,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated complications, healthcare associated infections,readmission, payment bundling, potentially preventable events and outcomes, and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) User Fee Program H.R.160 - Protect Medical Innovation Act S.149 - Medical Device Access and Innovation Protection Act H.R.2 - Medicare Access - CHIP Reauthorization Act H.R.1470 - SGR Repeal & Medicare Provider Payment Modernization Act S.1695, FY2016 Labor/Health and Human Services and Education Appropriations Bill H.R. 3422 VA Vendor Verification Act H.R. 2029, The Consolidated Appropriations Act of 2015 HR 1185 Responsible Additions and Increases to Sustain Employee Health Benefits Act HR 4469 Health Savings Act S 2499 Health Savings Act Health Savings Accounts; Flexible Spending Accounts HR 5273 Helping Hospitals Improve Patient Care Act Medicaid waiver policy Access to dental coverage H.R. 6274, The Hospital Outcomes Act

Client expense: $540,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated complications, healthcare associated infections,readmission, payment bundling, potentially preventable events and outcomes, and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) User Fee Program H.R.160 - Protect Medical Innovation Act S.149 - Medical Device Access and Innovation Protection Act H.R.2 - Medicare Access - CHIP Reauthorization Act H.R.1470 - SGR Repeal & Medicare Provider Payment Modernization Act S.1695, FY2016 Labor/Health and Human Services and Education Appropriations Bill H.R. 3422 VA Vendor Verification Act H.R. 2029, The Consolidated Appropriations Act of 2015 HR 1185 Responsible Additions and Increases to Sustain Employee Health Benefits Act HR 4469 Health Savings Act S 2499 Health Savings Act Health Savings Accounts; Flexible Spending Accounts HR 5273 Helping Hospitals Improve Patient Care Act Medicaid waiver policy Access to dental coverage

Client expense: $610,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections,readmissions, payment bundling, potentially preventable events,and value based purchasing. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) H.R. 2 - Medicare Access & CHIP Reauthorization Act H.R. 1470 - SGR Repeal & Medicare Provider Payment Modernization Act HR 5273 Helping Hospitals Improve Patient Care Act

Client expense: $610,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Implementation of Health care reform generally pertaining to pediatric healthcare and autism services Medicaid program reforms, including hospital outpatient department regulations H.R. 546 and S.298 (ACE Kids Act of 2015), all provisions Section 340B Drug Pricing program H.R. 6 and H.R. 34(21st century cures Act), entire bill and senate companion FDA reform legislation generally Stark Law Reform generally H.R. 5273 (Helping Hospitals Improve Patient Care Act of 2016), Section 201, regarding hospital outpatient departments Hospital Outpatient Prospective payment system regulations regarding hospital outpatient department regulations Federal Policy regarding United Network for Organ Sharing (UNOS) and allocation of donated organs Re-authorization of Children's Hospital Graduate Medical Education program Sickle Cell Disease research funding generally re-authorization of Children's Health Insurance Program Pediatric cancer research generally

Client expense: $121,385 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.34-21st Century Cures Act H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.953-Comprehensive Addiction and Recovery Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1641-Jason Simcakoski Memorial Opioid Safety Act H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2366-Field EMS Modernization and Innovation Act H.R.2463-Dispose Responsibly of your Pills (DROP) Act of 2015 H.R.2536-Recovery Enhancement for Addiction Treatment (TREAT) Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2805-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.2872-Opioid Addiction Treatment Modernization Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3014-Medical Controlled Substances Transportation Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3250-DXM Abuse Prevention Act of 2015 H.R.3299-Strengthening Public Health Emergency Response Act H.R.3537-Synthetic Drug Control Act of 2015 H.R.3677-Opioid Abuse Prevention and Treatment Act of 2015 H.R.3680-Co-Prescribing to Reduce Overdose Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3691-Improving Treatment for Pregnant and Postpartum Women Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.3865-Cradle Act H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4063-Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act H.R.4365-Protecting Patient Access to Emergency Medications Act of 2016 H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.4447-Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act H.R.4499-Promoting Responsible Opioid Prescribing Act of 2016 H.R.4599-Reducing Unused Medications Act of 2016 H.R.4641-To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes. H.R.4697-Prevevent Drug Addiction Act of 2016 H.R.4771-Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R.4732-Advancing Medical Resident Training in Community Hospitals Act of 2016 H.R.5243-Zika Response Appropriations Act H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 H.Res.877-Encouraging each State to enact legislation that increases the likelihood of survival after sudden cardiac arrest in our Nation's schools. S.141-Protecting Seniors Access to Medicare Act of 2015 S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.524-Comprehensive Addiction and Recovery Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.636-Increasing the Safety of Prescription Drug Use Act of 2015 S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.954-FDA Accountability for Public Safety Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1134-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 S.1392-Safer Prescribing of Controlled Substances Act S.1410-Treatment and Recovery Investment Act S.1431-Prescription Drug Abuse Prevention and Treatment Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1455-Recovery Enhancement for Addiction Treatment Act S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2256-Co-Prescribing Saves Lives Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2562-Heroin and Prescription Drug Abuse Prevention and Reduction Act S.2567-Preventing Overprescribing for Pain Act of 2016 S.2578-Reducing Unused Medications Act of 2016 S.2597-Medicare Mental Health Access Act S.2671-Advancing Medical Resident Training in Community Hospitals Act of 2016 S.2680-Mental Health Reform Act of 2016 S.2687-Plan of Safe Care Improvement Act S.2932-Protecting Patient Access to Emergency Medications Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016 S. 3407, Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths (MISSION ZERO) Act P.L.114-10-Medicare Access and CHIP Reauthorization Act of 2015 P.L.114-324-Justice for All Reauthorization Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Reimbursement environment for hospitals. Barriers to care coordination. Site-Neutral Payments. GME Funding. ACE Kids Act (H.R.546, S.298) Senate Chronic Care Working Group. MACRA implementation. Helping Hospitals Improve Patient Care Act (H.R. 5273). Treatment of off-campus HOPDs (H.R. 34).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Post Acute Care Payment Reform, Home Health Prior Authorization Requirements, H.R. 441-To provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 202-A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, Value Based Purchasing, Long term acute care hospital reimbursements, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015, S. 1211-A bill to amend title XVIII of the Social Security Act to provide that payment under the Medicare program to a long-term care hospital for inpatient services shall not be made at the applicable site neutral payment rate for certain discharges involving severe wounds, and for other purposes, S. 202- A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 2108-A bill to amend title XVIII of the Social Security Act to provide for an extension of certain long-term care hospital payment rules and the moratorium on the establishment of certain hospitals and facilities., H.R. 5273-Helping Hospitals Improve Patient Care Act of 2016, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare payments for Graduate Medical Education Proposed changes to Medicare hospital reimbursement policies Proposed cuts and policy changes to Medicare Advantage insurance plans H.R. 1343/S. 688, "Establishing Beneficiary Equity in the Hospital Readmissions Program Act" H.R. 3292, "Medicare IME Pool Act of 2015" H.R. 5273, "Helping Hospitals Improve Patient Care Act" H.R. 34, "21st Century Cures Act" - provisions related to Medicare payments to hospitals

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 1479, Mandating state specific budget neutrality for the rural area wage index floor H.R. 3292, "Medicare IME Pool Act of 2015" H.R. 5273, "Helping Hospitals Improve Patient Care Act" H.R. 34, "21st Century Cures Act" - provisions related to Medicare payments to hospitals

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Hospital Payment Issues, H.R. 5273-Helping Hospitals Improve Patient Care Act of 2016, H.R. 3298-Medicare Post-Acute Value-Based Purchasing Act of 2015, Medicare Bad Debt, Restoration of ACA Hospital Medicare Cuts

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Graduate Medical Education Health Care Delivery and Payment Reform proposals H.R. 3292, "Medicare IME Pool Act of 2015" H.R. 5273, "Helping Hospitals Improve Patient Care Act" H.R. 34, "21st Century Cures Act" - provisions related to Medicare payments to hospitals

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 1479, Mandating state specific budget neutrality for the rural area wage index floor H.R. 3292, "Medicare IME Pool Act of 2015" H.R. 5273, "Helping Hospitals Improve Patient Care Act" H.R. 34, "21st Century Cures Act" - provisions related to Medicare payments to hospitals

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Medicare payment policies for hospital outpatient departments H.R. 5273, "Helping Hospitals Improve Patient Care Act" Issues related to the Hospital Compare Star Ratings H.R. 34, "21 Century Cures Act" - provisions related to Medicare hospital payments

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2124, S. 1148, Resident Physician Shortage Reduction Act of 2015, Issues pertaining to the training of residents. H.R. 4774, Training Tomorrow's Doctors Today Act, Issues pertaining to the training of residents. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. H.R. 5273, Helping Hospitals Improve Patient Care Act, Issues pertaining to hospital outpatient departments payments for off-campus departments. H.R. 1343, S. 688, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, Issues pertaining to adjustment for socioeconomic status in the hospital re-admissions program. Issues related to the proposed Medicare Part B Drug Model. Issues related to the implementation of MACRA. Issues pertaining to the implementation of provisions regarding the treatment of off-campus hospital departments and site neutral payments. Issues pertaining to protecting Medicaid. Issues pertaining to protecting Disproportionate Share Hospital Payments. Issues pertaining to the protection of reimbursements for safety net hospitals. Issues pertaining to the CMS Center for Medicare and Medicaid Innovation and the University of Illinois Coordination of HealthCare for Complex Kids Program. Issues pertaining to the 340B drug pricing program.

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

Government targets: Defense, Dept of (DOD), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Natl Science Foundation (NSF), SENATE, Treasury, Dept of

Preventive Health Savings Act (H.R. 3660/S. 3126) House FY17 Labor, Health and Human Services, and Education and Related Agencies (Labor-HHS) Appropriations Bill Comprehensive Addiction and Recovery Act of 2016 (H.R. 953/S. 524) Helping Hospitals Improve Patient Care Act of 2016 (H.R. 5273) Hospital outpatient department reimbursement legislation (no specific bill number) Hospital Quality Rating Transparency Act of 2016 (H.R. 6088) 21st Century Cures Act (H.R. 6, H.R. 34) Senate Health Innovations Package Improving Health Information Technology Act (S. 2511) Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act (S. 3056) The ACO Improvement Act (H.R. 6101)

Client expense: $370,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE