Rural Community Hospital Demonstration Extension Act of 2015

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

Client expense: Not reported · Firm income: Not reported

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

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

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

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

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

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

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

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

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

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

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

Client expense: Not reported · Firm income: Not reported

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

Client expense: Not reported · Firm income: Not reported

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA)

Client expense: Not reported · Firm income: Not reported

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA)

Client expense: Not reported · Firm income: Not reported

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016

Client expense: Not reported · Firm income: Not reported

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Support H.R.672 and S.607, the Rural Community Hospital Demonstration Extension Act of 2015 and H.R. 5273 the Helping Hospitals Improve Patient Care Act of 2016

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

Government targets: Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Natl Oceanic & Atmospheric Administration (NOAA), SENATE, Transportation, Dept of (DOT), U.S. Forest Service

Plans for repeal and replacement of the Affordable Care Act and its impacts to access to care and payments to hospitals, specifically cuts to hospital payments under the ACA that allowed for greater coverage for individuals Revised 21st Century Cures bill (includes the hospital provisions, including demo project and direct supervision of outpatient therapies for 2016) Regulatory reform for hospitals including many of the issues addressed in the following legislation: Critical Access Hospital (CAH) Relief Act of 2015 (S. 258/H.R. 169) Protecting Access to Rural Therapy Services (PARTS) Act (S. 257/H.R. 1611) Rural Hospital Access Act of 2015 (S. 332/H.R. 663) Community Hospital Demonstration Extension Act of 2015 (S. 607/H.R. 672) Act to Reform Recover Audit Contractors (RACs) (H.R. 2156) Rural Emergency Acute Care Hospital (REACH) Act (S. 1648) Save Rural Hospitals Act (H.R. 3225) Critical Access and Rural Equity (CARE) Act (H.R. 4553) Direct Supervision 2016 Extension of Moratorium (S.3129/H.R. 5613); and H.R. 5614 for permanent moratorium Rural Hospital Regulatory Relief Act (H.R. 5164) Critical Access and Rural Equity (CARE) Act (H.R. 4553) Helping Hospitals Improve Patient Care Act of 2016 (H.R. 5273) Implementation of MACRA Concerns with implementation of Sec. 603 site-neutral reductions to Iowa hospitals and the CMS interpretation of the legislation in the outpatient prospective payment system proposed rule Concern with Hospital star ratings, and Hospital Quality Rating Transparency Act of 2016 (HR 5927) Iowa's proposed state plan amendment to incorporate intergovernmental transfers Significant concerns with Iowa's proposed transition to Medicaid managed care MedPAC recommendations for cuts to hospital payments avoiding site-neutral cuts recovery audit contractor (RAC) program and needed transparency and changes protecting critical access hospital funding and necessary provider status rural hospitals and access to care in Iowa encouraging value-based purchasing hospital acquired conditions and other quality measures Medicare formula and Iowa's payment compared to payments to other states Iowa hospital's economic impact to communities and the state beneficiary access throughout Iowa and threats from regulatory burdens and changes importance of 340B program to Iowa's hospitals Changes to the definition of patient in the 340B guidance and impact on Iowa hospitals Hospital outpatient department grandfathering provision to include currently planned facilities and acquisitions at time of enactment of H.R.1314 - Bipartisan Budget Act of 2015 (covered in revised and passed 21st Century Cures bill)

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support H.R.672 and S.607, the Rural Community Hospital Demonstration Extension Act of 2015 and H.R. 5273 the Helping Hospitals Improve Patient Care Act of 2016

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

Government targets: Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Natl Oceanic & Atmospheric Administration (NOAA), SENATE, Transportation, Dept of (DOT), U.S. Forest Service

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Critical Access Hospital (CAH) Relief Act of 2015 (S. 258/H.R. 169) Protecting Access to Rural Therapy Services (PARTS) Act (S. 257/H.R. 1611) Rural Hospital Access Act of 2015 (S. 332/H.R. 663) Community Hospital Demonstration Extension Act of 2015 (S. 607/H.R. 672) Act to Reform Recover Audit Contractors (RACs) (H.R. 2156) Rural Emergency Acute Care Hospital (REACH) Act (S. 1648) Save Rural Hospitals Act (H.R. 3225) Critical Access and Rural Equity (CARE) Act (H.R. 4553) Direct Supervision 2016 Extension of Moratorium (S.3129/H.R. 5613); and H.R. 5614 for permanent moratorium Rural Hospital Regulatory Relief Act (H.R. 5164) Critical Access and Rural Equity (CARE) Act (H.R. 4553) Helping Hospitals Improve Patient Care Act of 2016 (H.R. 5273) Proposed rule on implementation of MACRA Proposed FY2017 Hospice Wage Index Comments regarding the HHS budget proposal to change payment of CAH from 101% to 100% of costs Concerns with implementation of Sec. 603 site-neutral reductions to Iowa hospitals and the CMS interpretation of the legislation in the outpatient prospective payment system proposed rule Concern with Hospital star ratings, and Hospital Quality Rating Transparency Act of 2016 (HR 5927) Significant concerns with Iowa's proposed transition to Medicaid managed care Medicare reduction proposals in President Obama's budget released 2015 MedPAC recommendations for cuts to hospital payments avoiding site-neutral cuts recovery audit contractor (RAC) program and needed transparency and changes protecting critical access hospital funding and necessary provider status rural hospitals and access to care in Iowa encouraging value-based purchasing hospital acquired conditions and other quality measures Medicare formula and Iowa's payment compared to payments to other states Iowa hospital's economic impact to communities and the state beneficiary access throughout Iowa and threats from regulatory burdens and changes importance of 340B program to Iowa's hospitals Changes to the definition of patient in the 340B guidance and impact on Iowa hospitals Extension of sequestration against Medicare and the inclusion of the "site neutral" hospital outpatient department payment change in H.R.1314 - Bipartisan Budget Act of 2015 Hospital outpatient department grandfathering provision to include currently planned facilities and acquisitions at time of enactment of H.R.1314 - Bipartisan Budget Act of 2015 Concerns about processing and preauthorization, access to care issues with the Veteran's Choice program.

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169 / S. 258: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Critical Access Hospital (CAH) Relief Act of 2015 (S. 258/H.R. 169) Protecting Access to Rural Therapy Services (PARTS) Act (S. 257/H.R. 1611) Rural Hospital Access Act of 2015 (S. 332/H.R. 663) Community Hospital Demonstration Extension Act of 2015 (S. 607/H.R. 672) Act to Reform Recover Audit Contractors (RACs) (H.R. 2156) Rural Emergency Acute Care Hospital (REACH) Act (S. 1648) Save Rural Hospitals Act (H.R. 3225) Critical Access and Rural Equity (CARE) Act (H.R. 4553) Direct Supervision 2016 Extension of Moratorium (S.3129/H.R. 5613) Rural Hospital Regulatory Relief Act (H.R. 5164) Critical Access and Rural Equity (CARE) Act (H.R. 4553) Proposed rule on implementation of MACRA Proposed FY2017 Hospice Wage Index Comments regarding the HHS budget proposal to change payment of CAH from 101% to 100% of costs Significant concerns with Iowa's proposed transition to Medicaid managed care Medicare reduction proposals in President Obama's budget released 2015 MedPAC recommendations for cuts to hospital payments avoiding site-neutral cuts recovery audit contractor (RAC) program and needed transparency and changes protecting critical access hospital funding and necessary provider status rural hospitals and access to care in Iowa encouraging value-based purchasing hospital acquired conditions and other quality measures Medicare formula and Iowa's payment compared to payments to other states Iowa hospital's economic impact to communities and the state beneficiary access throughout Iowa and threats from regulatory burdens and changes importance of 340B program to Iowa's hospitals sustainable growth rate fix and impact on hospitals in Iowa Meaningful use in EHR Changes to the definition of patient in the 340B guidance and impact on Iowa hospitals Extension of sequestration against Medicare and the inclusion of the "site neutral" hospital outpatient department payment change in H.R.1314 - Bipartisan Budget Act of 2015 Clarifying amendment to hospital outpatient department grandfathering provision to include currently planned facilities and acquisitions at time of enactment of H.R.1314 - Bipartisan Budget Act of 2015 Concerns about processing and preauthorization, access to care issues with the Veteran's Choice program.

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Support H.R.672 and S.607, the Rural Community Hospital Demonstration Extension Act of 2015 and H.R. 5273 the Helping Hospitals Improve Patient Care Act of 2016

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

Government targets: Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Natl Oceanic & Atmospheric Administration (NOAA), SENATE, Transportation, Dept of (DOT)

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169 / S. 258: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169 / S. 258: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program and that Stage 3 not begin until 75 percent of EHs, CAHs and EPs attain Stage 2.; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records.

Support H.R. 672 and S. 607, the Rural Community Hospital Demonstration Extension Act of 2015.

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

Government targets: Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

Critical Access Hospital (CAH) Relief Act of 2015 (S. 258/H.R. 169) Protecting Access to Rural Therapy Services (PARTS) Act (S. 257/H.R. 1611) Rural Hospital Access Act of 2015 (S. 332/H.R. 663) Community Hospital Demonstration Extension Act of 2015 (S. 607/H.R. 672) Act to Reform Recover Audit Contractors (RACs) (H.R. 2156) Rural Emergency Acute Care Hospital (REACH) Act (S. 1648) Save Rural Hospitals Act (H.R. 3225) Critical Access and Rural Equity (CARE) Act (H.R. 4553) Significant concerns with Iowa's proposed transition to Medicaid managed care Medicare reduction proposals in President Obama's budget released 2015 MedPAC recommendations for cuts to hospital payments avoiding site-neutral cuts recovery audit contractor (RAC) program and needed transparency and changes protecting critical access hospital funding and necessary provider status rural hospitals and access to care in Iowa encouraging value-based purchasing hospital acquired conditions and other quality measures Medicare formula and Iowa's payment compared to payments to other states Iowa hospital's economic impact to communities and the state beneficiary access throughout Iowa and threats from regulatory burdens and changes importance of 340B program to Iowa's hospitals sustainable growth rate fix and impact on hospitals in Iowa Meaningful use in EHR Changes to the definition of patient in the 340B guidance and impact on Iowa hospitals Extension of sequestration against Medicare and the inclusion of the "site neutral" hospital outpatient department payment change in H.R.1314 - Bipartisan Budget Act of 2015 Clarifying amendment to hospital outpatient department grandfathering provision to include currently planned facilities and acquisitions at time of enactment of H.R.1314 - Bipartisan Budget Act of 2015 Concerns about processing and preauthorization, access to care issues with the Veteran's Choice program.

Support H.R. 672 and S. 607, the Rural Community Hospital Demonstration Extension Act of 2015.

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

Government targets: Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, SENATE

HALO letter sent to Congress about the Medicare Sustainable Growth Rate (SGR) for physician payment; Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program and that Stage 3 not begin until 75 percent of EHs, CAHs and EPs attain Stage 2.; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support HR 2, Medicare Access and CHIP Reauthorization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Childrens Health Insurance Program; Support HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals; Support S 629, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Oppose Recovery Audit Contracts (RACs)Section 3 that imposes financial penalties on RACs; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 1295, Trade Preferences Extension Act of 2015because the inclusion of the Medicare sequestration offset; Oppose HR 976 and HR 2513Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records.

H.R. 170: Rural Health Care Provider Relief Act of 2015 S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act H.R. 169 / S. 258: Critical Access Hospital Relief Act of 2015 H.R. 270: Flexibility in Health IT Reporting Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 H.R. 2878 / S. 1461: Would implement a one-year moratorium on enforcement of the supervision requirements for outpatient therapeutic services H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act H.R. 1314: Bipartisan Budget Act of 2015

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Critical Access Hospital (CAH) Relief Act of 2015 (S. 258/H.R. 169) Protecting Access to Rural Therapy Services (PARTS) Act (S. 257/H.R. 1611) Rural Hospital Access Act of 2015 (S. 332/H.R. 663) Community Hospital Demonstration Extension Act of 2015 (S. 607/H.R. 672) Act to Reform Recover Audit Contractors (RACs) (H.R. 2156) Rural Emergency Acute Care Hospital (REACH) Act (S. 1648) Save Rural Hospitals Act (H.R. 3225) Significant concerns with Iowa's proposed transition to Medicaid managed care Medicare reduction proposals in President Obama's budget released 2015 MedPAC recommendations for cuts to hospital payments avoiding site-neutral cuts recovery audit contractor (RAC) program and needed transparency and changes protecting critical access hospital funding and necessary provider status rural hospitals and access to care in Iowa encouraging value-based purchasing hospital acquired conditions and other quality measures Medicare formula and Iowa's payment compared to payments to other states Iowa hospital's economic impact to communities and the state beneficiary access throughout Iowa and threats from regulatory burdens and changes importance of 340B program to Iowa's hospitals sustainable growth rate fix and impact on hospitals in Iowa Meaningful use in EHR Changes to the definition of patient in the 340B guidance and impact on Iowa hospitals Extension of sequestration against Medicare and the inclusion of the "site neutral" hospital outpatient department payment change in H.R.1314 - Bipartisan Budget Act of 2015 Clarifying amendment to hospital outpatient department grandfathering provision to include currently planned facilities and acquisitions at time of enactment of H.R.1314 - Bipartisan Budget Act of 2015 Support for the Bay State fix in the Continuing Resolution

Client expense: $65,000 · Firm income: Not reported

HALO letter sent to Congress about the Medicare Sustainable Growth Rate (SGR) for physician payment; Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which provide incentives and penalties to encourage meaningful use of EHRs by hospitals and physicians and to extend non-enforcement instruction for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibilityadvocate for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support HR 2, Medicare Access and CHIP Reauthorization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Childrens Health Insurance Program; Support HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals; Support S 629, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Oppose Recovery Audit Contracts (RACs)Section 3 that imposes financial penalties on RACs; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Discussions to oppose site neutral payments. Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 1295, Trade Preferences Extension Act of 2015because the inclusion of the Medicare sequestration offset; Oppose HR 976 and HR 2513Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process.

Support H.R. 672 and S. 607, the Rural Community Hospital Demonstration Extension Act of 2015.

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

Government targets: Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 672, S. 607, Rural Community Hospital Demonstration Program Extension

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Critical Access Hospital (CAH) Relief Act of 2015 (S. 258/H.R. 169) Protecting Access to Rural Therapy Services (PARTS) Act (S. 257/H.R. 1611) Rural Hospital Access Act of 2015 (S. 332/H.R. 663) Community Hospital Demonstration Extension Act of 2015 (S. 607/H.R. 672) Act to Reform Recover Audit Contractors (RACs) (H.R. 2156) Rural Emergency Acute Care Hospital (REACH) Act (S. 1648) Save Rural Hospitals Act (H.R. 3225) Significant concerns with Iowa's proposed transition to Medicaid manged care Medicare reduction proposals in President Obama's budget released 2015 MedPAC recommendations for cuts to hospital payments avoiding site-neutral cuts recovery audit contractor (RAC) program and needed transparency and changes protecting critical access hospital funding and necessary provider status rural hospitals and access to care in Iowa encouraging value-based purchasing hospital acquired conditions and other quality measures Medicare formula and Iowa's payment compared to payments to other states Iowa hospital's economic impact to communities and the state beneficiary access throughout Iowa and threats from regulatory burdens and changes importance of 340B program to Iowa's hospitals sustainable growth rate fix and impact on hospitals in Iowa Meaningful use in EHR

Client expense: $65,000 · Firm income: Not reported

H.R. 170: Rural Health Care Provider Relief Act of 2015 S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act H.R. 169 / S. 258: Critical Access Hospital Relief Act of 2015 H.R. 270: Flexibility in Health IT Reporting Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 H.R. 2652: Protecting Patients and Physicians Against Coding Act of 2015 H.R. 2247: Increasing Clarity for Doctors by Transitioning Effectively Now Act H.R. 2126: Cutting Costly Codes Act of 2015 H.R. 2878 / S. 1461: Would implement a one-year moratorium on enforcement of the supervision requirements for outpatient therapeutic services H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Critical Access Hospital (CAH) Relief Act of 2015 (S. 258/H.R. 169) Protecting Access to Rural Therapy Services (PARTS) Act (S. 257/H.R. 1611) Rural Hospital Access Act of 2015 (S. 332/H.R. 663) Community Hospital Demonstration Extension Act of 2015 (S. 607/H.R. 672) Medicare and Childrens Health Insurance Program (CHIP) Reauthorization Act (H.R. 2) Rural Emergency Acute Care Hospital (REACH) Act (S. 1648) Trade Adjustment Assistance funding issue regarding use of sequestration to fund the program Proposed 2016 Hospice wage Index Rule Medicare reduction proposals in President Obama's budget released 2015 MedPAC recommendations for cuts to hospital payments avoiding site-neutral cuts recovery audit contractor (RAC) program and needed transparency and changes protecting critical access hospital funding and necessary provider status rural hospitals and access to care in Iowa encouraging value-based purchasing hospital acquired conditions and other quality measures Medicare formula and Iowa's payment compared to payments to other states Iowa hospital's economic impact to communities and the state beneficiary access throughout Iowa and threats from regulatory burdens and changes importance of 340B program to Iowa's hospitals sustainable growth rate fix and impact on hospitals in Iowa

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

HALO letter sent to Congress about the Medicare Sustainable Growth Rate (SGR) for physician payment; Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which provide incentives and penalties to encourage meaningful use of EHRs by hospitals and physicians and to extend non-enforcement instruction for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibilityadvocate for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support HR 2, Medicare Access and CHIP Reauthorization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Childrens Health Insurance Program; Support HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals; Support S 629, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Oppose Recovery Audit Contracts (RACs)Section 3 that imposes financial penalties on RACs; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Discussions to oppose site neutral payments. Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 1295, Trade Preferences Extension Act of 2015because the inclusion of the Medicare sequestration offset; Oppose HR 976 and HR 2513Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program, and for other purposes.

Support H.R. 672 and S. 607, the Rural Community Hospital Demonstration Extension Act of 2015.

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

Government targets: Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, SENATE