Medical Care Access Protection Act of 2006

Health Information Technology H.R. 747, the "National Health Information Incentive Act" H.R. 4642, the "Wired for Healthcare Quality Act" (companion to S. 1418) H.R. 4157, the "Health Information Technology Promotion Act of 2006" H.R. 4641, the Assisting Doctors to Obtain Proficient and Transmissible Health Information Technology (ADOPT HIT) Act of 2005 S. 1418, the Wired for Healthcare Quality Act S. 1355, the Better Healthcare Through Information Technology S. 1227, the Health Information Technology Act of 2005 - CMS/OIG Stark and Anti-kickback statute protections for donating health information technology Expanding Health Insurance Coverage H.R. 1399, the HealthCARE Act of 2005 S. 1049, the Covering Kids Act, S. 2772, Health Partnership Act - Health insurance reform - Medicaid - Association Health Plans, Medical Savings Accounts - Tax credits and purchasing pools Medical liability reform H.R. 5, S.11, the HEALTH Act of 2005 S. 22, Medical Care Access Protection Act of 2006 - Medical liability demonstration projects Medicare Physician Payment/Medicare Reform H.R. 2356, the Preserving Patient Access to Physicians Act S. 1356, the Medicare Value Purchasing Act of 2005 H.R. 3617, the Medicare Value-Based Purchasing for Physician Services Act S. 40, the Geriatric and Chronic Care Management Act S. 2071, the Community and Rural Medical Residency Preservation Act of 2005' H.R. 4403, the Community and Rural Medical Residency Preservation Act of 2005 H.R. 5866, Medicare Physician Payment Reform and Quality Improvement Act of 2006 - Reform of SGR, Value-based purchasing, Pay-for-Performance - Patient Centered Medical Home, Care coordination - Primary care shortage - CMS proposed changes to work relative value units (RVUs) - Medically Unbelievable Edits program - CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC) - CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates - Health Care Price Transparency FY 07 Appropriations H.R. 5647, FY 2007 appropriations for Labor/HHS/Education (including Title VII health professions and student loans) and VA healthcare and research; S. 3708, FY 2007 appropriations for Labor/HHS/Education (including Title VII health professions and student loans) and VA healthcare and research Public Health Issues - Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza) - CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration - DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act Student Loan Debt Relief H.R. 1338, College Loan Assistance Act H.R. 1380, Higher Education Affordability and Equity Act

Client expense: $584,100 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE, UNDETERMINED, White House Office

HR 525 Small Business Health Fairness Act of 2005 S. 1955 Small Business Health Insurance Marketplace Modernization and Affordability Act HR 4859 Federal Family Health Information Technology Act S. 22 Medicare Care Assess Protection Act S. 2563 Pharmacist Assess and Recognition in Medicare Act HR 5166 Independent Pharmacy Protection Act S. 2510 Small Employers Health Benefits Program HR 4157 Health Information Technology Promotion Act S. 1355 Health Information Technology and Improvement Act S. 1356 Medicare Value Purchasing Act HR 3205 Patient Safety and Quality Improvement Act

Client expense: $240,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of, White House Office

17. House(s) of Congress and Federal Agencies Contacted (Continued) General Accounting Office, health Resources and Services Administration, Office of Management and Budget, U.S. House of Representatives, U.S. Senate S.22 & S.23 - Medical Liability Reform S.1356 - Medicare Value Based Purchasing Act S.2020 - Tax Relief Act S.2071 - Community and Rural Medical Residency Preservation Act S.3708 - FY 2007 Labor/HHS/Ed Appropriations Bill Healthcare Group Purchasing P.L.109-171 - Deficit Reduction Act Value-Based Medicare Purchasing H.R.4157 - The Health Information Technology Promotion Act of 2006 H.R.4297 - Tax Relief Extension Reconciliation Act H.R.5171 - The Communities Building Access Act H.R.5647 - FY 2007 Labor/HHS/Ed Appropriations Bill

Client expense: $170,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S.22 Medical Care Access Protection Act of 2006 S.23 Healthy Mothers and Healthy Babies Access to Care Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medical Care Access Act (S.22) Mental Health Parity Act (H.R. 1402) The Wired for Healthcare Quality Act (S. 1418 Health Information Technology Promotion Act (H.R. 4157) Flex Health Savings Account Act (H.R. 4511) Medicare Quality Enhancement Act (S. 3900)

Client expense: $129,512 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

S. 852, S. 3274 Fairness in Asbestos Injury Resolution Act of 2005 – provisions regarding standards for medical criteria for those with nonmalignant asbestos related diseases, timing of filing cause of actions and waiver of statute of limitations H.R. 5, S. 354, S.22, Help Efficient, Accessible, Low-cost, Timely Healthcare or the Health Act of 2005 – issue of preemption of state medical liability laws S. 23, Healthy Mothers and Healthy Babies Access to Care Act – issue of preemption of state medical liability laws H.R. 420 Lawsuit Abuse Reduction Act – provisions regarding modifications to Rule 11 of the Federal Rules of Civil Procedure and changes relating to jurisdiction and venue for personal injury cases filed in state and federal courts S. 1337, the Fair and Reliable Medical Justice Act – provisions regarding the creation of health care tribunals H.R. 1546, Medical Liability Procedural Reform Act of 2005 – provisions regarding the creation of health care tribunals H.R. 5309, Medicare Secondary Payer and Workers' Compensation Settlement Agreements Act of 2006 – provisions relating to criteria for review of Medicare set-asides and rules for establishing a Medicare set-aside in Workers’ Compensation Cases. General issues relating to alternatives to Medical Malpractice Litigation

Client expense: $560,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Commission on Civil Rights, U.S. Copyright Office, U.S. Trade Representative (USTR), White House Office

S.354/H.R.534 Medicaid Liability Reform S.473/H.R.215 Allied Health Professions Reinvestment Act of 2005 Act S.544 Patient Safety and Quality Improvement Act of 2005 S.681 Umbilical Cord Blood Stem Cell Research S.898/H.R.1812 Patient Navigator Outreach & Chronic Disease Prevention Act of 2005 S.933/H.R.2350 Rural Community Hospital Assistance Act S.1049 Covering Kids Act of 2005 S.1262/H.R.2234 Health Technology to Enhance Quality Act of 2005 & the 21st Century Health Information Act S.1355 & S.1262 Better Healthcare Through Information Technology Act S.1356/H.R.3617 Medicare Value Purchasing Act of 2005 S.1418 Wired for Health Care Quality Act S.1784 National Medical Error Disclosure & Compensation Act of 2005 S.1955 Health Insurance Marketplace Modernization & Affordability Act of 2005 S.3042 All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act H.R.139 Health Improvement and Professionals Act of 2005 H.R.534 Rural Health Equity Act H.R.880 Rural Health Equity Act H.R.3173 Nurse Faculty Higher Education Act H.R.3373/S.1405 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act H.R.3607 The Future of Health Care-Granting Access to Innovation in America Act H.R.4157 Health Information Technology Promotion Act of 2005/Hospital Pricing Transparency H.R.5647/S.3708 Labor-Health and Human Services Educaiton Bill FFY 2007 Budget and Budget Resolutions 2007 Medicare Inpatient Hospital PPS Rules 2007 Medicare Inpatient Psychiatric Facility PPS Rules 2007 Medicare Inpatient Rehabilitation Facility PPS and “75% Rule”, Rules 2007 Medicare Outpatient PPS Rules 2007 Medicare Skilled Nursing Facility PPS Rules 2007 Medicare Home Health Agency PPS Rules 2007 Medicare Physician Fee Schedule Update “Stark” and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting states’ Medicaid financing mechanisms Pay for Performance Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare Wage Index Community Benefit Reporting Mental health parity Limited service hospitals HUD Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting; hospital performance measure reporting S.4 Health Technology to Enance Quality Act of 2005 S.22 Medical Care Access Protection Act of 2006 S.23 Healthy Mothers and Healthy Babies Access S.338/H.R.985 bipartisan Medicaid Commission

Client expense: $420,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

HR 525, S 406, H. Res. 379 (Small Business Health Fairness Act of 2005) -- access to podiatrists HR 2355, S 1015 (Health Care Choice Act of 2005) -- impact on practicing podiatric medicine HR 5, HR 534, H. Res. 385, S 354, S 366, and S 367 (Help Efficient, Accessible, Low-cost, Timely Healthcare Act of 2005 and other medical liability bills) -- impact on practicing podiatric medicine S 1955 (Health Insurance Marketplace Modernization and Affordability Act of 2005) -- access to podiatrists S 22 (Medical Care Access Protection Act of 2006) -- impact on practicing podiatric medicine S 2510 (Small Employers Health Benefits Program Act of 2006) -- access to podiatrists

Client expense: $220,000 · Firm income: Not reported

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

HR 5246, HR 5348, S 2990, Medicare Teaching Anesthesiology Funding Restoration Act of 2006; HR 6184, Medicare Academic Anesthesiology and CRNA Payment Improvement Act of 2006; HR 5688, Healthcare Truth and Transparency Act of 2006 HR 5647, S 3708, FY 07 Labor HHS Education Appropriations; HR 2528, Military Quality of Life and Veterans Affairs Appropriations Act 2006 ; HR 534, HR 385, HR 4838, S 22, Help Efficient Accessible Low Cost Timely Healthcare (HEALTH) Act of 2005

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR5647 – Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2007 HR810 - Stem Cell Research Enhancement Act of 2005 S471 – Stem Cell Research Enhancement Act of 2005 S2754 - Alternative Pluripotent Stem Cell Therapies Enhancement Act HR1357 - Human Cloning Prohibition Act of 2005 HR5574 - Children's Hospital GME Support Reauthorization Act of 2006 HR5573 - Health Centers Renewal Act of 2006 S22 - Medical Care Access Protection Act of 2006 HR4997 - Physicians for Underserved Areas Act S2425 - To apply amendments to the Immigration and Nationality Act related to providing medical services in underserved areas, and for other purposes S2564 - Biodefense and Pandemic Vaccine and Drug Development Act of 2006 S3504 - Fetus Farming Prohibition Act of 2006 S843 - Combating Autism Act of 2006 HR6164 - National Institutes of Health Reform Act of 2006 HR4239 - Animal Enterprise Terrorism Act HR5533 - Biodefense and Pandemic Vaccine and Drug Development Act of 2006

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

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Natl Oceanic & Atmospheric Administration (NOAA), Natl Science Foundation (NSF), Office of the Vice President of the United States, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA)

HR 1360 HR 1546, HR 1957, HR 2291, HR 2399, HR 2400, HR 2657, HR 3076, HR 3359, HR 3378, HR 3865, HR 3875, HR 420, HR 4838, S 1337, S 1525, S 1788, S 22, S 23, S 3274, S 354, S 367, S 668, S 852

Client expense: $3,216,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care liability legislation (S354/HR 534, HR5, S354, S356, S367, S 2750, S 1337, HR.3875/S 2750, S 22, S23, HR 3875)

Client expense: $680,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

S. 3274, Fairness in Asbestos Injury Resolution Act of 2006. H.R. 420, Lawsuit Abuse Reduction Act of 2005 (LARA). H.R. 1038, Multidistrict Litigation Restoration Act of 2005. H.R. 1360, Fairness in Asbestos Injury Resolution Act of 2005. H.R. 1957, Asbestos Compensation Fairness Act of 2005. S. 852, Fairness in Asbestos Injury Resolution Act of 2005. S. 908, Commonsense Consumption Act of 2005. S. 4/S. 1503, Healthy America Act of 2005. S. 22, Medical Care Access Protection Act.

Client expense: $1,870,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of, White House Office

H.R. 2650: “Patient Protection Act” (Norwood); H.R. 3204: “State High Risk Pool Funding Extension Act” (Shadegg); H.R. 4157: “Health Information Technology Promotion Act” (Johnson); H.R. 4519: “State High Risk Pool Funding Extension Act” (Shadegg); H.R. 4859: “Federal Family Health Information Technology Act” (Porter); H.R. 5559: “Independent Health Record Bank Act”; H.R. 6053: "Health Care Price Transparency Act" (Burgess); S. 4: “Healthy America Act” (Frist); S. 22: “Medical Care Access Protection Act” (Ensign); S. 23: “Healthy Mothers and Healthy Babies Access to Care Act” (Santorum); S. 288: “State High Risk Pool Funding Extension Act” (Gregg); S. 306: “Genetic Information Nondiscrimination Act” (Snowe); S. 1012: “Patients’ Bill of Rights Act” (Kennedy); S. 1262: “Health Technology to Enhance Quality Act” (Frist-Clinton); S. 1337: “Fair and Reliable Medical Justice Act” (Enzi-Baucus); S. 1355: “Health Information Technology Quality and Improvement Act” (Enzi-Kennedy); S. 1418: “Wired for Health Care Quality Act” (Enzi); S. 2300: “Lower Prices Reduced with Increased Competition and Efficient Development of Drugs Act” (Stabenow-Lott); S. 2772: “Health Partnership Act” (Voinovich-Bingaman); S. 3454: “Independent Health Record Bank Act” (Brownback); S. 3582: "Preserve Access to Affordable Generics Act" (Kohl); S. 3701 "Catastrophic Health Coverage Promotion Act" (Smith-Wyden); S. 3776 "State-Based Health Care Reform Act" (Feingold); and S. 3846 "Federal Employees Electronic Personal Health Records Act" (Carper). HCR (Regulatory Issues): HIPAA administrative simplification issues, including privacy, security, and electronic transactions and code sets; FEHBP enrollment data clearinghouse initiative; FEHBP community rating policies, including similarly sized subscriber group (SSSG) requirements; health plan compliance with Executive Order 13224; implementation of the health savings account provisions of the Medicare Act; issues related to implementation of the National Health Information Infrastructure; implementation of the National Provider Identifier (NPI) standards; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; and ERISA requirements for benefit plan reporting. HCR (Legislative Issues): H.R. 5: “HEALTH Act” (Gingrey); H.R. 1227: “Genetic Information Nondiscrimination Act” (Biggert); H.R. 1402: “Mental Health Equitable Treatment Act” (Kennedy-Ramstad); H.R. 2259: “Patients’ Bill of Rights Act” (Dingell) (continued)

Client expense: $3,700,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of

HR 2671, Healthcare Truth & Transparency Act S 2480, Contact Lens Consumer Protection Act HR 534/ S 354/ S 22, Medical Liability Reform HR 5, the HEALTH ACT CMS-1321 FC and CMS-1317 F: Medicare Program; Revisions to Payment Policies, Five Year Review of Work Relative Value Units, Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B. CMS-1321-P (Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2007 and Other Changes to Payment Under Part B; Proposed Rule) CMS-1506-P; CMS-4125-P (Medicare Program; Hospital Outpatient Prospective Payment System and CY 2007 Payment Rates; Ambulatory Surgical Center List of Covered Procedures; Ambulatory Surgical Center Payments System and CY2008 Payment Rates CMS-1512-PN; Medicare Program; Five Year Review of Work Relative Value Units under the Physician Fee Schedule and Proposed Changes to the Practice Expense Methodology HR 2328/ HR2238/ S 3685 Children's Access to Vision Act; HR 6227/ S 3685 Kids Vision Care Act HR 2356/ HR 6111/ HR 5866/ S 1081, Medicare Fee Fix HR 3617/ S 1356, Pay for Performance HR 4042/ S 1884, ACS Payment Modernization

Client expense: $601,100 · Firm income: Not reported

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

S. 467 - Terrorism Risk Insurance Extension Act of 2005 - All provisions H.R. 1153 - Terrorism Insurance Backstop Extension Act of 2005 - All provisions Flood Insurance Reauthorization - All provisions H.R. 420 - Lawsuit Abuse Reduction Act of 2005 - All provisions H.R. 5637 - Non-admitted and Reinsurance Reform Act of 2006 - All provisions S. 3239 - Uniform Insurance Non-Coverage Disclosure Act - All provisions S. 2509 - National Insurance Act of 2006 - All provisions S. 852 - Fairness in Asbestos Injury Resolution Act of 2005 - All provisions H.R. 1360 - Fairness in Asbestos Injury Resolution of 2005 - All provisions H.R. 1546 - Medical Liability Procedural Reform Act of 2005 H.R. 1957 - Asbestos Compensation Fairness Act of 2005 - All provisions H.R. 2291 - Medical Malpractice Relief Act of 2005 - All provisions H.R. 2399 - Improved Medical Malpractice Information Reporting and Competition Act of 2005 - All provisions H.R. 2400 - Emergency Malpractice Liability Insurance Commission (EMLIC) Act - All provisions H.R. 2657 - Comprehensive Medical Malpractice Reform Act of 2005 - All provisions H.R. 3076 - Freedom From Unnecessary Litigation Act of 2005 - All provisions H.R. 3359 - Medical Malpractice and Insurance Reform Act of 2005 - All provisions H.R. 3378 - Comprehensive Medical Malpractice Reform Act of 2005 - All provisions H.R. 3515 - Truth in Automobile Insurance Rates Act of 2005 - All provisions H.R. 3865 - Medical Malpractice Insurance Corporation Act - All provisions H.R. 3875 - Access to Emergency Medical Services Act of 2005 - All provisions H.R. 4838 - Medical Malpractice Reform Act of 2006 - All provisions S. 22 - Medical Care Access Protection Act of 2006 (MCAP) - All provisions S. 354 - HEALTH Act of 2005 - All provisions S. 668 - Asbestos Standards Enforcement Act of 2005 - All provisions S. 852 - Fair Act of 2005 - All provisions S. 1337 - Fair and Reliable Medical Justice Act - All provisions S. 1525 - Medical Malpractice Insurance Antitrust Act of 2005 - All provisions S. 1788 - Libby Health Care Act - All provisions S. 2509 - National Insurance Act of 2006 - All provisions S. 3274 - Fair Act of 2006 - All provisions S. 4025 Insurance Industry Antitrust Enforcement Act of 2006 H.R. 6225 - National Insurance Act of 2006 - All provisions Insurance Regulatory Reform Legislation (SMART) - No Bill Number, Introduction Pending in House - All provisions

Client expense: $1,660,000 · Firm income: Not reported

Government targets: Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

HR 5115-U.S Healthcare Technologies Competitiveness Act of 2006 (Bill to modernize the tax treatment as related to medical devices and biomedical research corporations) HR 4388-Tax Revision Act of 2005 (Bills to amend the Internal Revenue Code of 1986 to extend certain expiring provisions) HR 4297-Tax Relief Extension Reconciliation Act of 2005 (Bill to extend credit for increasing research activities) HR 4845-Innovation and Competitiveness Act HR 1736/S 627-Investment in America Act of 2005 (Bills to make permanent the tax credit for increasing research activities) S 978-Healthcare Tax Relief for the Uninsured Act of 2005 HR 1872-Health Coverage for the Uninsured Act of 2005 (Bills to provide tax incentives for the purchase of quality health care, and for other purposes) HR 5-Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act of 2005 (Bill to provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system) HR 6406-The Tax Relief and Health Care Act of 2006 (Bill to improve temporarily certain rates of duty and make other technical amendments to the trade laws, and to extend certain trade preference programs) S Cong Res 67/H Cong Res 311-Concurrent resolution urging Japan to honor its commitments under the 1986 Market-Oriented Sector-Selective (MOSS) Agreement on Medical Equipment and for other purposes (Bill to reduce regulatory barriers to the approval and adoption of new medical technologies) S 2467-United States Trade Enhancement Act of 2006 (Congressional resolutions on trade enforcement efforts as relates to trade with China) S 295-To authorize appropriate action if the negotiations with the People’s Republic of China’s undervalued currency are not successful) (Bill to impose an additional duty of 27.5% on Chinese imports) HR 3004-Currency Harmonization Initiative through Neutralizing Action Act of 2005 (Bill to impose additional tariffs on Chinese imports on the basis of the rate of manipulation by that country of the rate of exchange between the Chinese currency and the U.S dollar) HR 3283/S 1421-United States Trade Rights Enforcement Act (Bills to enhance resources to enforce U.S trade rights) HR 4157-Health Information Technology Promotion Act of 2005 (Bill to provide for establishment of uniform confidentiality and security standards with respect to individually identifiable patient health information) S 1355-Better Healthcare Through Information Technology Act S 1418-Wired for Health Care Quality Act (Bills to enhance the adoption of health information technology and to improve the quality and reduce the cost of healthcare in the United States) S 1952-Critical Access to Health Information Technology Act of 2005 (Bill to provide for grants to states to increase access to health care in rural areas by improving health information technology) S 1223-Information Technology for Health Care Quality and Improvement Act (Bill to improve the quality and efficiency of health care delivery through improvements in health care information technology) S 1262-Health Technology to Enhance Quality Act of 2005 (Bill to reduce healthcare costs, improve efficiency and healthcare quality through the development of a nation-wide interoperable health information technology system) S 2480-Contact Lens Consumer Protection Act (Bill to amend the Fairness to Contact Lens Consumers Act with respect to the availability of contact lenses) HR 6111-Tax Relief and Health Care Act of 2006 (President Bush signed into Public Law # 109-432 on 12/20/2006) HR 5975-Prescription Drug Comparative Effectiveness Act of 2006 (Bill to require the Agency for Healthcare Research and Quality, in consultation with NIH Director, to conduct research to develop valid scientific evidence regarding clinical effectiveness, outcomes, and appropriateness as relates to medical devices and procedures and for other purposes) S 4098-Pediatric Medical Devices and Safety Improvement Act of 2006 (Bill to improve the process for development of needed pediatric medical devices) S 3778-Small Business Reauthorization and Improvements Act of 2006 HR 5352-Small Business Reauthorization Act of 2006 (Bills to reauthorize programs to assist small business concerns) S 1263-Save America’s Biotechnology Innovative Research Act of 2005 HR 2943-Save Biotechnology Innovative Research Act of 2005 (Bills to establish eligibility requirements for business concerns to receive awards under the Small Business Innovative Research program) S 3678-Pandemic and All Hazards Preparedness Act (Bill with respect to public health security and all-hazards preparedness and response, and for other purposes) HR2863-Division E – Public Readiness and Emergency Preparedness Act (Division E provisions of the bill as relates to targeted liability for pandemic and epidemic products and security countermeasures) S 2564/HR 5533-Biodefense and Pandemic Vaccine and Drug Development Act of 2006 S 1873-Biodefense and Pandemic Vaccine and Drug Development Act of 2005 (Bills to prepare and strengthen the development of countermeasures or pandemic or epidemic products against deliberate, accidental, and natural outbreaks of illness) S-1880-National Biodefense and Pandemic Preparedness Act of 2005 (Bill to enhance biodefense and pandemic preparedness activities) S 2792-Emergency Preparedness and Response Security, Accountability, and Flexibility Enhancement Act (SAFE Act) (Bill to revise provisions relating to bioterrorism and other public health emergencies preparedness grants including development of measurable critical benchmarks and performance standards) S 3-Protecting American in the War on Terror Act of 2005 (Bill sets provisions concerning bioterrorism preparedness and defense as pertaining to medical devices and for other purposes) S 975-The Project Bioshield II Act of 2005 (Bill to provide incentives to increase research by private sector entities to develop medial countermeasures to prevent, detect, identify, contain, and treat illnesses, including those associated with biological, chemical, nuclear, or radiological weapons attack or an infectious disease outbreak) S 22/S23-Malpractice Liability Reform Bill (a.k.a. Medical Care Access Protection Act of 2006, MCAP Act) (Bills setting forth provisions regulating lawsuits for health care liability claims related to the provision of health care services) HR 2090- Food and Drug Administration Improvement Act of 2005 (Bill related to FDA Advisory panels) S. 3807-Enhancing Drug Safety and Innovation Act of 2006 (Draft bill to improve oversight as related to drugs includes medical devices in some provisions)

Client expense: $1,404,102 · Firm income: Not reported

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

Allied health Professions Reinvestment Act of 2005 (S.473/H.R.215); Patient Safety and Quality Improvement Act of 2005 (S.544); Rural Community Hospital Assistance Act (S.933/H.R.2350); Health Technology to Enhance Quality Act of 2005 & 21st Century Health Information Act (S.1262/H.R.2234); Medicare Value Purchasing Act of 2005 (S.1356/H.R.3617); National Medical Error Disclosure & Compensation Act of 2005 (S.1784); Health Improvement and Professionals Act of 2005 (H.R.139); Rural Health Equity Act (H.R.534/H.R.880); Health Information Technology Promotion Act of 2005/Hospital Pricing Transparency (H.R.4157); FFY 2007 Budget and Budget Resolutions; FFY 2007 Medicare Inpatient Hospital PPS Rules; FFY 2007 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule; CY 2007 Medicare Outpatient PPS Rules; Pay for Performance; Not for Profit Hospital Tax-Exempt Status; Medicaid Regulations Affection States' Medicaid Financing Mechanisms; Hospital Charity Care/Financial Aid; Emergency Preparedness; Medicare Wage Index; Health Care Workforce Recruiting and Training Funding; Medical Error Reporting Health Technology to Enhance Quality Act of 2005 (S.4); Medical Care Access Protection Act of 2006 (S.22); Bipartisan Medicaid Commission (S.338/H.R.985); Medicaid Liability Reform (S.354/H.R.534);

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 23 Health Mothers and Healthy Babies Access to Care Act of 2006, Improve women's access to health care OB-GYN services; S 22 Medical Care Access Protection Act of 2006, Improve patient access to health care services; S 3678 Pandemic and All Hazards Preparedness Act, To amend the Public Health Service Act with respect to public health security and all-hazards preparedness and response, and for other purposes; S 367 Pregnancy and Trauma Care Access Protection Act of 2005, Improve women's access to emergency and trauma care services; S 1337 The Fair and Reliable Medical Justice Act, Restore fairness to medical justice system and promote patient safety; S 1418 Wired for Healthcare Quality Act, Adoption of nationwide health information system; HR 3875 Access to Emergency Medical Services Act of 2005, Improve access to emergency medical services through medical liability reform and Medicare payments; HR 4157 The Health Information Technology Promotion Act of 2006, Promote better health information system; HR 5573 Health Centers Renewal Act of 2006, Provide appropriations for health centers; HR 4997 Physician for Underserved Areas Act, To extend for 2 years the authority to grant waivers of the foreign country residence requirement with respect to certain international medical graduates; HR 1285 Amend the Nursing Relief for Disadvantaged Areas Act of 1999, To extend for 3 years changes to requirements for admission of non-immigrant nurses in health professional shortage areas; HR 4859 Federal Family Health Information Technology Act of 2006, To amend chapter 89 of title 5, United States Code, to provide for the implementation of a system of electronic health records under the Federal Employees Health Benefits Program. S 1355 Better Healthcare Through Information Technology Act, Enhances health information technology; S 1262 Health TEQ Act of 2005, Development of nationwide health information system;

Client expense: $140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tax Reconciliation Bill - H.R. 4297 and S. 22 - Dividends and Synfuels

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 22, Medical Care Access Protection (MCAP) Act, all provisions relating to medical liability; S. 23 Healthy Mothers and Healthy Babies Access to Care Act, all provisions relating to medical liability; S. 23 Healthy Mothers and Healthy Babies Access to Care Act, all provisions relating to medical liability; S. 354, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2005, all provisions relating to medical liability; S. 366, Healthy Mothers and Healthy Babies Access to Care Act of 2005, all provisions relating to medical liability; S. 367, Pregnancy and Trauma Care Access Protection Act of 2005, all provisions relating to medical liability; S. 4 and S. 1503, Healthy America Act of 2005, Title I subtitle A, provisions related to medical liability lawsuits; S. 1337, Fair and Reliable Medical Justice Act, all provisions relating to medical liability; S. 1058 and HR 1313, Community Health Center Volunteer Physician Protection Act, all provisions relating to medical liability; HR 3359, Medical Malpractice and Insurance Reform Act of 2005, Title II, provisions relating to lawsuits; HR 3875, Access to Emergency Medical Services Act of 2005, Title I, provision regarding medical liability reform; HR 2657, Comprehensive Medical Malpractice Reform Act of 2005, Titles I & II, provisions regarding medical liability; HR 3378, Comprehensive Medical Malpractice Reform Act of 2005, Titles I & II, provisions regarding medical liability; S. 1747, Good Samaritan Liability Improvement and Volunteer Encouragement (GIVE) Act of 2005, Title I, provisions related to liability for volunteers; HR 1546, Medical Liability Procedural Reform Act, all provisions relating to medical liability; HR 4838, Medical Malpractice Reform Act of 2006, all provisions relating to medical liability; HR 6246, Physicians and Taxpayers Protection from Frivolous Litigation Act, all provisions relating to medical liability; S. 2750, Access to Emergency Medical Services Act, Title I, provisions regarding medical liability. HR 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2005, all provisions relating to medical liability; HR 534, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2005, all provisions relating to medical liability;

Client expense: $140,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

S 1262, Health Technology to Enhance Quality Act of 2005. State high-risk health insurance pools - HR 4519, State High Risk Pool Funding Extension Act of 2005. Association health plans - HR 525, Small Business Health Fairness Act of 2005; HR 1872, Health Coverage for the Uninsured Act of 2005; HR 5288, Small Business Health Plans Act of 2006; HR 5262, Tax Free Health Savings Act of 2006; HR 6134, Health Opportunity Patient Empowerment Act of 2006; S 406, Small Business Health Fairness Act of 2005; S 1955, Health Insurance Marketplace Modernization and Affordability Act of 2005; S 2510, Small Employers Health Benefits Program Act of 2006 HR 5, HEALTH Act; HR 1227, Genetic Information Non discrimination Act; HR 1402, Mental Health Equitable Treatment Act; HR 2259, Patients' Bill of Rights Act; HR 2650, Patient Protection Act; HR 3204, State High Risk Pool Funding Extension Act; HR 4859, Federal Family Health Information Technology Act; HR 5559, Independent Health Record Bank Act; HR 6053, Health Care Price Transparency Promotion Act; S 4, Healthy America Act; S 22, Medical Care Access Protection Act; S 23, Healthy Mothers and Healthy Babies Access to Care Act; S 288, State high Risk Pool Extension Act; S 306, Genetic Information Nondiscrimination Act; S 1012, Patients' Bill of Rights Act; S 1337, Fair and Reliable Medical Justice Act; S 2300 Lower Prices Reduced with Increased Competition and Efficient Development of Drugs Act; S 2772, Health Partnership Act; S 3454, Independent Health Record Act; S 3582, Preserve Access to Affordable Generics Act; S 3701, Catastrophic Health Coverage Promotion Act; S 3776, State-based Health Care Reform Act; S 3846, Federal Employees Electronic Personal Health Records Act Healthcare for the uninsured - Legislative proposal concerning this issue. Health information technology - HR 4157, Health Information Technology Promotion Act of 2005; S 1418, Wired for Health Care Quality Act; S 1355, Better Healthcare Through Information Technology Act;

Client expense: Not reported · Firm income: $180,000

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

S.23 Healthy Mothers and Healthy Babies Access,S.338/H.R.985 Bipartisan Medicaid Commission S.354/H.R.534 Medicaid Liability Reform,S.473/H.R.215 Allied Health Professions Reinvestment Act of 2005 Act S.544 Patient Safety and Quality Improvement Act of 2005,S.681 Umbilical Cord Blood Stem Cell Research S.898/H.R.1812 Patient Navigator Outreach & Chronic Disease Prevention Act of 2005 S.1049 Covering Kids Act of 2005,S.1262/H.R.2234 Health Technology to Enhance Quality Act of 2005 & the 21st Century Health Information Act,S.1355 & S.1262 Better Healthcare Through Information Technology Act S.1356/H.R.3617 Medicare Value Purchasing Act of 2005,S.1418 Wired for Health Care Quality Act S.1784 National Medical Error Disclosure & Compensation Act of 2005, S.1955 Health Insurance Marketplace Modernization & Affordability Act of 2005 S.3042 All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act H.R.534 Rural Health Equity Act,H.R.880 Rural Health Equity Act,H.R.3173 Nurse Faculty Higher Education Act H.R.3373/S.1405 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act H.R.3607 The Future of Health Care-Granting Access to Innovation in America Act H.R.4157 Health Information Technology Promotion Act of 2005/Hospital Pricing Transparency H.R.5647/S.3708 Labor-Health and Human Services Education Bill FFY 2007 Budget and Budget Resolutions 2007 Medicare Inpatient Hospital PPS Rules 2007 Medicare Inpatient Psychiatric Facility PPS Rules 2007 Medicare Inpatient Rehabilitation Facility PPS and “75% Rule”, Rules 2007 Medicare Outpatient PPS Rules 2007 Medicare Skilled Nursing Facility PPS Rules 2007 Medicare Home Health Agency PPS Rules 2007 Medicare Physician Fee Schedule Update “Stark” and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting states’ Medicaid financing mechanisms Pay for Performance Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration S.4 Health Technology to Enhance Quality Act of 2005 S.22 Medical Care Access Protection Act of 2006

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.354/H.R.534 Medicaid Liability Reform,S.473/H.R.215 Allied Health Professions Reinvestment Act of 2005 Act S.544 Patient Safety and Quality Improvement Act of 2005S.681 Umbilical Cord Blood Stem Cell Research, S.898/H.R.1812 Patient Navigator Outreach & Chronic Disease Prevention Act of 2005,S.933/H.R.2350 Rural Community Hospital Assistance Act, S.1049 Covering Kids Act of 2005 S.1262/H.R.2234 Health Technology to Enhance Quality Act of 2005 & the 21st Century Health Information Act S.1355 & S.1262 Better Healthcare Through Information Technology Act, S.1356/H.R.3617 Medicare Value Purchasing Act of 2005,S.1418 Wired for Health Care Quality Act,S.1784 National Medical Error Disclosure & Compensation Act of 2005 S.1955 Health Insurance Marketplace Modernization & Affordability Act of 2005,S.3042 All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act,H.R.139 Health Improvement and Professionals Act of 2005 H.R.534 Rural Health Equity Act,H.R.880 Rural Health Equity Act,H.R.3173 Nurse Faculty Higher Education Act H.R.3373/S.1405 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act H.R.3607 The Future of Health Care-Granting Access to Innovation in America Act H.R.4157 Health Information Technology Promotion Act of 2005/Hospital Pricing Transparency H.R.5647/S.3708 Labor-Health and Human Services Educaiton Bill, FFY 2007 Budget and Budget Resolutions,2007 Medicare Inpatient Hospital PPS Rules,2007 Medicare Inpatient Psychiatric Facility PPS Rules,2007 Medicare Inpatient Rehabilitation Facility PPS and “75% Rule”, Rules,2007 Medicare Outpatient PPS Rules, 2007 Medicare Skilled Nursing Facility PPS Rules,2007 Medicare Home Health Agency PPS Rules 2007 Medicare Physician Fee Schedule Update, “Stark” and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting states’ Medicaid financing mechanisms Pay for Performance Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration S.4 Health Technology to Enhance Quality Act of 2005, S.22 Medical Care Access Protection Act of 2006 S.23 Healthy Mothers and Healthy Babies Access, S.338/H.R.985 Bipartisan Medicaid Commission

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

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

H.R. 3617 Medicare Value- Based Purchasing for Physicians, Service act of 2005 S. 3585 HSA Improvement and Expansion Act of 2006 H.R. 6111 Tax Relief & Healthcare Act of 2006 H.R. 5864 Health partnership through creative Federalism Act H.R. 5743 HSA Improvement and Expansion Act of 2006 S. 3701 Catastrophic health Coverage Promotion Act S. 3776 State Based Healthcare Reform Act H.R. 4519 State High Risk Pool funding Extension Act of 2005 S.250 Carl Perkins Career & Technical Education Improvement Act of 2006 H.R. 1285 Nursing Relief for Disadvantage Areas reauthorization Act of 2006 S. 16 Affordable Health Care Act S. 1227 Health Information Technology Act of 2005 S. 1262 Health Technology to Enhance Quality Act S. 1355 Better Healthcare Through Information Technology Act H.R.747 National Health Information Incentive Act H.R. 2234 21st Century Health Information Act H.R. 4157 Health Information Technology Promotion Act of 2005 H.R. 5647 Department of Labor, Health and Human Services , and Education and Related Agencies Appropriations Act of 2007 S. 1789 Personal Data Privacy and Security Act of 2005 S. 3568 Data Security Act of 2006 S. 1408 Identity theft Protection Act S. 751 Notification of Risk to Personal Data Act S. 500 Information Protection and Security Act H.R. 1080 Information Protection and Security Act S. 1322 Personal Data Privacy and Security Act of 2005 H.R. 3997 Financial data Protection Act of 2006 H.R. 4127 Data Accountability and Trust Act S. 1932 Deficit Reduction Act of 2005 S. 2510 Small Employers Health Benefits Program Act of 2006 S. 2382 Small Employers Health Benefits Program Act of 2006 S. 2701 To Amend the e Internal Revenue Code of 1986 to Provide Refundable Credit for High Deductible Health Plans for Uninsured Individuals S. 2507 National Defense Authorization Act of Fiscal year 207 H.R. 5475 HSA Accessibility And Portability Act of 2006 H.R. 5613 Health Insurance Tax Credit Assistance act of 2006 H.R. 4961 Self- Employed Health Care Affordability Act of 2006 H.R. 5288 Small Business Health Plans Act of 2006 S. 2549 Health Savings Account Affordability Act S. 2607 Small Business Health Education and Awareness Act of 2006 S.2558 Keep America Competitive Tax Credit Act of 2006 H.R. 2355 Health Care Choice Act of 2005 H.R. 5586 HSA Premium Affordability Act of 2006 H.R. 4760 All Kids Health Insurance Coverage Act of 2006 S. 2759 Medicare Part D outreach and Enrollment Enhancement Act of 2006 H.R. 5171 Communities Building Access Act H. RES 802 Whereas Medicare Now offers a Prescription Drug Benefit for its Beneficiaries, Known as Medicare Part D S. 3585 HSA Improvement and Expansion Act of 2006 H.R. 4838 Medical Malpractice Reform Act of 2006 H.R. 2631 Department of Defense Appropriations Act, 2007 S. 3708 Department of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act of 2007 S. 22 MCAP Act S. 2750 Access to Emergency Medical Services Act of 2006 H.R. 4838 Medical Malpractice Act of 2006 S. 1356 Medicare Value Purchasing Act of 2005 S. 1418 Wired for Health Care Quality Act

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 366, "Healthy Mothers and Healthy Babies Access to Care Act of 2005" H.R 1020, "National Pain Care Policy Act of 2005" S. 1418, "Wired for Health Care Quality Act" S. 1355, " Better Healthcare Through Information Technology Act" S. 1262, " Health TEQ Act of 2005" Dispensing of Controlled substances for legitimate medical treatment of pain. FDA warning label for Propofol. H.R. 5688, " Healthcare Truth and Transparency Act of 2006" H.R. 5, " Help, Efficient, Accessible, Low-cost, Timely Health Care Act" S. 23, " Healthy Mothers and Healthy Babies Access to Care Act" S. 22, " Medical Care Access Protection Act"

Client expense: $620,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE

Health care liability legislation (S354/HR 534, HR5, S354, S356, S367, S 2750, S 1337, HR.3875/S 2750, S 22, S23)

Client expense: $360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE, White House Office

Health Technology to Enhance Quality Act of 2005 (S.4); Medical Care Access protection Act of 2006 (S.22); Bipartisan Medicaid Commission (S.338/H.R.985); Medicaid Liability Reform (S.354/H.R.534); Allied Health Professions Reinvestment Act of 2005 (S.473/H.R.215); Patient Safety and Quality Improvement Act of 2005 (S.544); Rural Community Hospital Assistance Act (S.933/H.R.2350); Health Technology to Enhance Quality Act of 2005 & the 21st Century Health Information Act (S.1262/H.R.2234); Medicare Value Purchasing Act of 2005 (S.1356/H.R.3617); National Medical Error Disclosure & Compensation Act of 2005 (S.1784); Health Improvement and Professionals Act of 2005 (H.R.139); Rural Health Equity Act (H.R.534/H.R.880); Health Information Technology Promotion Act of 2005/Hospital Pricing Transparency (H.R.4157); FFY 2007 Budget and Budget Resolutions; FFY 2007 Medicare Inpatient Hospital PPS Rules; FFY 2007 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule; CY 2007 Medicare Outpatient PPS Rules; Pay for Performance; Not-for-profit Hospital Tax-Exempt Status; Medicaid Regulations Affecting States' Medicaid Financing Mechanisms; Hospital Charity Care/Financial Aid; Emergency Preparedness; Medicare Wage Index; Health Care Workforce Recruiting and Training Funding; Medical Error Reporting

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE