Home and Community Services Copayment Equity Act of 2006

MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, bidding and payment (including Part D reinsurance and low income subsidies), benefit design rules, SSA and CMS premium withhold processing issues, systems issues affecting enrollment and disenrollment processing, enrollment rules, marketing materials review and approval, measurement and oversight of plan performance, grievance and appeals processes, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval, systems issues affecting enrollment and disenrollment processing, payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, grievance and appeals processes, beneficiary information requirements, and other issues affecting Medicaid health plan operations; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Children’s Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; and implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and CMS RFI concerning health information technology. H.R. 4297: “Tax Relief Extension Reconciliation Act” (Thomas); H.R. 4719: Medicare Advantage Funding (Dingell); H.R. 5166: “Independent Pharmacy Protection Act” (Wicker); H.R. 5399: “Medicare Drug Benefit Enrollment Fairness Act" (Johnson); H.R. 4939: “Emergency Supplemental Appropriations Act” (Lewis); H.R. 5647: Labor-HHS-Education Appropriations Act (Regula); H.R. 5866 "Medicare Physician Payment Reform and Quality Improvement Act" (Burgess); H.R. 6077: SCHIP Funding (Norwood); H.R. 6098 "Keep Children Covered Act" (Barrow); H.R. 6111: Medicare and Medicaid Provisions; H.R. 6164: SCHIP Funding (Barton); H.Con.Res. 376: Budget Resolution (Nussle); S. 124: Repeal of the Medicare Advantage Stabilization Fund (Feingold); S. 1356: “Medicare Value Purchasing Act” (Grassley-Baucus); S. 1778: QI-1 Extension/Ban on Coverage of ED Drugs (Grassley); S. 1932: Budget Reconciliation Bill (Gregg); S. 2255: “Medicare Drug Formulary Protection Act” (Feinstein-Collins); S. 2260: Medicare Advantage Funding (Clinton); S. 2354: “Medicare Prescription Drug Gap Reduction Act” (Nelson-Collins); S. 2409: “Home and Community Services Copayment Equity Act” (Smith-Bingaman); S. 2563: “Pharmacist Access and Recognition in Medicare Act” (Cochran); S. 2664: “Pharmacy Access Improvement Act” (Baucus); S. 2665: “Medicare Prescription Drug Simplification Act” (Baucus); S. 2810: “Medicare Late Enrollment Assistance Act” (Grassley-Baucus); S. 3647: "Prescription For Fairness Act" (Dorgan); S. 3897: "Medicare Data Access and Research Act" (Grassley); S. 3900: "Medicare Quality Enhancement Act" (Gregg); S. 3193: "Keep Children Covered Act" (Rockefeller); S. 3972: "Fair-SCHIP Act" (Grassley); S.Con.Res. 83: Budget Resolution (Gregg). MMM (Legislative Issues): H.R. 3617: “Medicare Value-Based Purchasing for Physicians' Services Act” (Johnson); H.R. 4241: Budget Reconciliation Bill (Nussle) (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 3617, Medicare Value-Based Purchasing for Physicians' Services Act of 2005; HR 4078, Maintaining Medicare Access Act of 2005; HR 5916, Patients' Access to Physicians Act of 2006; HR 4388, Tax Revision Act of 2005; HR 6408, Tax Relief and Health Care Act of 2006; HR 6111, Tax Relief and Health Care Act of 2006; S 1081, Preserving Patient Access to Physicians Act of 2005; S 1356, Medicare Value Purchasing Act of 2005. HR 4241, Budget Reconciliation Bill; HR 4297, Tax Relief Extension Reconciliation Act; HR 4719, Medicare Advantage Funding; HR 5166, Independent Pharmacy Protection Act; HR 5399, Medicare Drug Benefit Enrollment Fairness Act; HR 4939, Emergency Supplemental Appropriations Act; HR 5647, Labor-HHS-Education Appropriations Act; HR 5866, Medicare Physician Payment Reform and Quality Improvement Act; HR 6077, SCHIP Funding; HR 6098, Keep Children Covered Act; HR 6164, SCHIP Funding; H Con Res 376, Budget Resolution; S 124 Repeal of the Medicare Advantage Stabilization Act; S 1778, QI-1 Extension/Ban on Coverage of ED Drugs; S 1932, Budget Reconciliation Act; S 2255, Medicare Drug Formulary Protection Act; S 2260, Medicare Advantage Funding; S 2354, Medicare Prescription Drug Gap Reduction Act; S 2409, Home and Community Services Copayment Equity Act; S 2563, Pharmacist Access and Recognition in Medicare Act; S 2664, Pharmacy Access Improvement Act; S 2665, Medicare Prescription Drug Simplification Act; S 2810 Medicare Late Enrollment Assistance Act; S 3647, Prescription for Fairness Act; S 3897, Medicare Data Access and Research Act; S 3900, Medicare Quality Enhancement Act; S 3913, Keep Children Covered Act; S 3972, FAIR-SCHIP Act; S Con Res 83, Budget Resolution Implementation of Medicare Part C (Medicare Advantage) - Executive action concerning this issue. Medicare Part D - Executive action concerning this issue. Medicare update for physicians, stabilization fund - HR 2356, Preserving Patient Access to Physicians Act of 2005;

S.1356 – Medicare Value Purchasing Act S.1589 – Affordability in Medicare Premiums Act of 2005 S.18 – Meeting Our Responsibility to Medicare Beneficiaries Act of 2005 S.2072 – Medicare Early Access Act of 2005 S.2255 – Medicare Drug Formulary Protection Act S.2260 – Medicare Advantage Funding S.2354 – Medicare Prescription Drug Gap Reduction Act S.2409 – Home and Community Services Copayment Equity Act S.2563 – Pharmacist Access and Recognition in Medicare Act S.2664 – Pharmacy Access Improvement Act S.2665 – Medicare Prescription Drug Simplification Act S.2810 – Medicare Late Enrollment Assistance Act S.334 – Pharmaceutical Market Access and Drug Safety Act S.345 – Medicare Prescription Drug Savings and Choice Act of 2005 S.445 – Medicare Prescription Drug Price Reductions Act of 2005 S.566 – Medicare Dual Eligible Prescription Drug Coverage Act of 2005 S.581 – Medicare Prescription Drug Cost Containment Act of 2005 S.873 – Medicare Prescription Drug Savings and Choice Act of 2005 HR.3617 – Medicare Value-Based Purchasing for Physicians’ Services Act of 2005 HR.4557 – Medicare Prescription Drug Affordability Act of 2005 HR.5399 – Medicare Drug Benefit Enrollment Fairness Act S.124 – Repeal of the Medicare Advantage Stabilization Fund

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2354 – Medicare Prescription Drug Gap Reduction Act S.2409 – Home and Community Services Copayment Equity Act S.2563 – Pharmacist Access and Recognition in Medicare Act S.2664 – Pharmacy Access Improvement Act S.2665 – Medicare Prescription Drug Simplification Act S.2810 – Medicare Late Enrollment Assistance Act S.334 – Pharmaceutical Market Access and Drug Safety Act HR.5399 – Medicare Drug Benefit Enrollment Fairness Act S.2072 – Medicare Early Access Act of 2005 S.2255 – Medicare Drug Formulary Protection Act S.2260 – Medicare Advantage Funding

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.18 – Meeting Our Responsibility to Medicare Beneficiaries Act of 2005 S.2255 – Medicare Drug Formulary Protection Act S.2260 – Medicare Advantage Funding S.2354 – Medicare Prescription Drug Gap Reduction Act S.2409 – Home and Community Services Copayment Equity Act S.2563 – Pharmacist Access and Recognition in Medicare Act S.2664 – Pharmacy Access Improvement Act S.2665 – Medicare Prescription Drug Simplification Act S.2810 – Medicare Late Enrollment Assistance Act S.345 – Medicare Prescription Drug Savings and Choice Act of 2005 S.445 – Medicare Prescription Drug Price Reductions Act of 2005 S.566 – Medicare Dual Eligible Prescription Drug Coverage Act of 2005 S.581 – Medicare Prescription Drug Cost Containment Act of 2005 S.873 – Medicare Prescription Drug Savings and Choice Act of 2005 HR.4557 – Medicare Prescription Drug Affordability Act of 2005 HR.5399 – Medicare Drug Benefit Enrollment Fairness Act S.1356 – Medicare Value Purchasing Act S.1589 – Affordability in Medicare Premiums Act of 2005

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2260 – Medicare Advantage Funding S.2354 – Medicare Prescription Drug Gap Reduction Act S.2409 – Home and Community Services Copayment Equity Act S.2563 – Pharmacist Access and Recognition in Medicare Act S.2664 – Pharmacy Access Improvement Act S.2665 – Medicare Prescription Drug Simplification Act S.2810 – Medicare Late Enrollment Assistance Act HR.5399 – Medicare Drug Benefit Enrollment Fairness Act S.124 – Repeal of the Medicare Advantage Stabilization Fund S.1356 – Medicare Value Purchasing Act S.2255 – Medicare Drug Formulary Protection Act

Client expense: Not reported · Firm income: $105,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2260 – Medicare Advantage Funding S.2354 – Medicare Prescription Drug Gap Reduction Act S.2409 – Home and Community Services Copayment Equity Act S.2563 – Pharmacist Access and Recognition in Medicare Act S.2664 – Pharmacy Access Improvement Act S.2665 – Medicare Prescription Drug Simplification Act S.2810 – Medicare Late Enrollment Assistance Act HR.5399 – Medicare Drug Benefit Enrollment Fairness Act S.124 – Repeal of the Medicare Advantage Stabilization Fund S.1356 – Medicare Value Purchasing Act S.2255 – Medicare Drug Formulary Protection Act

Client expense: Not reported · Firm income: $150,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2255 – Medicare Drug Formulary Protection Act S.2260 – Medicare Advantage Funding S.2354 – Medicare Prescription Drug Gap Reduction Act S.2409 – Home and Community Services Copayment Equity Act S.2563 – Pharmacist Access and Recognition in Medicare Act S.2664 – Pharmacy Access Improvement Act S.2665 – Medicare Prescription Drug Simplification Act S.2810 – Medicare Late Enrollment Assistance Act HR.3617 – Medicare Value-Based Purchasing for Physicians’ Services Act of 2005 HR.5399 – Medicare Drug Benefit Enrollment Fairness Act S.124 – Repeal of the Medicare Advantage Stabilization Fund S.1356 – Medicare Value Purchasing Act

Client expense: Not reported · Firm income: $150,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE