Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015

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.

Client expense: $4,970,000 · Firm income: Not reported

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

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; implementation of H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform Act; H.R. 817, Fairness in Ambulence Reimbursement Act; Protecting Patient Access to Medications Act (H.R. 4365).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), the Fairness in Ambulance Reimbursement Act (H.R. 817).

Client expense: $260,000 · Firm income: Not reported

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

Medicare Ambulance Reimbursement; H.R. 745/S.377 - Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015; Ambulance reimbursement

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 745 & S. 377 the Protecting Access to Medicare Act of 2015; H.R. 817, the Fairness in Ambulance Reimbursement Act of 2015; S. 1149 and H.R. 822 related to air ambulance services; legislation regarding EMS administration of certain controlled substances; Implementation of HR 2 Medicare Access and CHIP Reauthorization Act of 2015, Pub. L. No 114-10; Implementation of P.L. 113-93, Protecting Access to Medicare Act; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including the extenders; and Medicare audit issues, including OMHA Proposed Rule, and ambulance prior authorization and moratoria, CY 2017 Physician Fee Schedule proposed rule.

Client expense: Not reported · Firm income: $40,500

Government targets: Centers For Medicare and Medicaid Services (CMS), 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,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.

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; implementation of H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform Act; H.R. 817, Fairness in Ambulence Reimbursement Act; Protecting Patient Access to Medications Act (H.R. 4365).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), the Fairness in Ambulance Reimbursement Act (H.R. 817).

Client expense: $300,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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,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.

HR 745 & S. 377 the Protecting Access to Medicare Act of 2015; H.R. 817, the Fairness in Ambulance Reimbursement Act of 2015; S. 1149 and H.R. 822 related to air ambulance services; legislation regarding EMS administration of certain controlled substances; Implementation of HR 2 Medicare Access and CHIP Reauthorization Act of 2015, Pub. L. No 114-10; Implementation of P.L. 113-93, Protecting Access to Medicare Act; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including the extenders; and Medicare audit issues, including OMHA Proposed Rule, and ambulance prior authorization and moratoria.

Client expense: Not reported · Firm income: $40,500

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

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; implementation of H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform Act; H.R. 817, Fairness in Ambulence Reimbursement Act; Protecting Patient Access to Medications Act (H.R. 4365).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Ambulance Reimbursement; H.R. 745/S.377 - Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), the Fairness in Ambulance Reimbursement Act (H.R. 817).

Client expense: $300,000 · Firm income: Not reported

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

HR 745, the Protecting Access to Medicare Act of 2015; H.R. 745 and S 377, the Fairness in Ambulance Reimbursement Act of 2015; S. 1149 and H.R. 822 related to air ambulance services; H.R. 2366, improvement of field emergency medical services bill; HR 2029 Omnibus; HR 2 Medicare Access and CHIP Reauthorization Act of 2015, Pub. L. No 114-10 and its implementation; Implementation of P.L. 113-93, Protecting Access to Medicare Act; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including the extenders and Ambulance Fee Schedule Proposed Rule and Medicare audit issues

Client expense: Not reported · Firm income: $40,500

Government targets: Centers For Medicare and Medicaid Services (CMS), 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.

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform Act and H.R. 817, Fairness in Ambulence Reimbursement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), the Fairness in Ambulance Reimbursement Act (H.R. 817).

Client expense: $300,000 · Firm income: Not reported

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

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. CMMI demonstration program. Mental health issues in general. ICD-10 Implementation. H.R. 546/ S. 298, ACE Kids Act of 2015. S.377/ H.R. 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015. S. 971, Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015.

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE

HR 745, the Protecting Access to Medicare Act of 2015; H.R. 745 and S 377, the Fairness in Ambulance Reimbursement Act of 2015; S. 1149 and H.R. 822 related to air ambulance services; H.R. 2366, improvement of field emergency medical services bill; HR 2029 Omnibus; HR 2 Medicare Access and CHIP Reauthorization Act of 2015, Pub. L. No 114-10 and its implementation; Implementation of P.L. 113-93, Protecting Access to Medicare Act; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including the extenders and Ambulance Fee Schedule Proposed Rule and Medicare audit issues

Client expense: Not reported · Firm income: $40,500

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

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform Act and H.R. 817, Fairness in Ambulence Reimbursement Act

Client expense: Not reported · Firm income: $40,000

Government targets: 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.

Medicare ambulance reimbursement; S. 1149/H.R. 822 - A bill to amend title XVIII of the Social Security Act to require reporting of certain data by providers and suppliers of air ambulance services for purposes of reforming reimbursements for such services under the Medicare program, and for other purposes; S. 377/H.R. 745 - Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), the Fairness in Ambulance Reimbursement Act (H.R. 817) and the FY2016 Omnibus Appropriations Bill (H.R. 2029)

Client expense: $300,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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, 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.

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. CMMI demonstration program. Mental health issues in general. ICD-10 Implementation. H.R. 546/ S. 298, ACE Kids Act of 2015. S.377/ H.R. 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015. S. 971, Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015.

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. CMMI demonstration program. Mental health issues in general. H.R. 2, Medicare Access and CHIP Reauthorization Act. S. 298/ H.R.546, ACE Kids Act of 2015. S.377/ H.R.745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015.

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

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

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform Act and H.R. 817, Fairness in Ambulence Reimbursement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 745, the Protecting Access to Medicare Act of 2015; H.R. 745 and S 377, the Fairness in Ambulance Reimbursement Act of 2015; S. 1149 and H.R. 822 related to air ambulance services; H.R. 2366, improvement of field emergency medical services bill; HR 2 Medicare Access and CHIP Reauthorization Act of 2015, Pub. L. No 114-10 and its implementation; Implementation of P.L. 113-93, Protecting Access to Medicare Act; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including the extenders and Ambulance Fee Schedule Proposed Rule and Medicare audit issues

Client expense: Not reported · Firm income: $42,000

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

Medicare ambulance reimbursement; S. 1149/H.R. 822 - A bill to amend title XVIII of the Social Security Act to require reporting of certain data by providers and suppliers of air ambulance services for purposes of reforming reimbursements for such services under the Medicare program, and for other purposes; S. 377/H.R. 745 - Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377) and the Fairness in Ambulance Reimbursement Act (H.R. 817).

Client expense: $300,000 · Firm income: Not reported

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

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. CMMI demonstration program. Mental health issues in general. H.R. 2, Medicare Access and CHIP Reauthorization Act. S. 298/ H.R.546, ACE Kids Act of 2015. S.377/ H.R.745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015.

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

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

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. CMMI demonstration program. Mental health issues in general. ICD-10 Implementation. H.R. 2, Medicare Access and CHIP Reauthorization Act. H.R. 546/ S. 298, ACE Kids Act of 2015. S.377/ H.R. 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015.

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), 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, 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.

HR 745, the Protecting Access to Medicare Act of 2015; H.R. 745 and S 377, the Fairness in Ambulance Reimbursement Act of 2015; S. 1149 and H.R. 822 related to air ambulance services; H.R. 2366, improvement of field emergency medical services bill; HR 2 Medicare Access and CHIP Reauthorization Act of 2015, Pub. L. No 114-10 and its implementation; Implementation of P.L. 113-93, Protecting Access to Medicare Act; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including the extenders and Ambulance Fee Schedule

Client expense: Not reported · Firm income: $45,000

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

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform Act and H.R. 817, Fairness in Ambulence Reimbursement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to the emergency medical services. H.R. 33/H.R. 1191/H.R. 2658/S. 420, the Protecting Volunteer Firefighters and Emergency Responders Act, provisions to clarify that volunteer firefighters are not considered to be employees under the Patient Protection and Affordable Care Act (P.L. 111-148). Issues regarding training of first responders to respond to an Ebola outbreak, including the use of federal grant programs. H.R. 1300, the First Responder Anthrax Preparedness Act, provisions to establish a voluntary anthrax vaccination program for first responders. H.R. 361, the Medical Preparedness Allowable Use Act, provisions to allow FEMA homeland security grant funds to be used to distribute medical countermeasures to first responders and their families. H.R.2366, the Field EMS Modernization and Innovation Act, provisions relating to federal programs affecting the emergency medical services. H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, and H.R. 745/ S. 377, the Medicare Ambulance Access, Fraud Prevention, and Reform Act, provisions relating to the extension of add-on payments for the transport of Medicare patients to hospitals.

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

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), the Fairness in Ambulance Reimbursement Act (H.R. 817) and the Medicare Access and CHIP Reauthorization Act (H.R. 2).

Client expense: $300,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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, which provide incentives and penalties to encourage meaningful use of EHRs by hospitals and physicians; 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 -- top ask given contingency fees are a no go; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Discussions to oppose site neutral payments.

HR 745, the Protecting Access to Medicare Act of 2015; S 377, the Protecting Access to Medicare Act of 2015; HR 2 Medicare Access and CHIP Reauthorization Act of 2015; Implementation of P.L. 113-93, Protecting Access to Medicare Act; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including the extenders and Ambulance Fee Schedule

Client expense: Not reported · Firm income: $45,000

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

Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues; H.R. 2, H.R. 745/S. 377, Medicare Ambulance Access, Fraud Prevention, and Reform act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied to improve Medicare ambulance policies and reimbursement. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), the Fairness in Ambulance Reimbursement Act (H.R. 817) and the Medicare Access and CHIP Reauthorization Act (H.R. 2).

Client expense: $300,000 · Firm income: Not reported

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