Medicare Quality Enhancement Act of 2006

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

HR 4157 Health Information Technology Promotion Act of 2006 - To amend the Social Security Act to encourage the dissemination, security, confidentiality, and usefulness of health information technology. HR 4511 Flex Health Savings Accounts Act of 2005 - To amend the Internal Revenue Code of 1986 to allow the use of flexible spending and health reimbursement arrangements in combination with health savings accounts, and for other purposes. HR 5262 Tax Free Health Savings Act of 2006 - To amend the Internal Revenue Code of 1986 to provide tax incentives for the payment of premiums for high deductible health plans, and for other purposes. HR 5743 HSA Improvement and Expansion Act of 2006 - To amend the Internal Revenue Code of 1986 to improve and expand the availability of health savings accounts, and for other purposes. S 1418 Wired for Health Care Quality Act - A bill to enhance the adoption of a nationwide inter operable health information technology system and to improve the quality and reduce the costs of health care in the United States. S 2558 Keep America Competitive Tax Credit Act of 2006 - A bill to amend the Internal Revenue Code of 1986 to provide a tax credit to employers for employee catastrophic health care costs and to health insurance companies for insurer catastrophic health care costs, and for other purposes. S 3900 Medicare Quality Enhancement Act of 2006 - A bill to amend title XVIII of the Social Security Act to improve the quality and efficiency of health care, to provide the pubic with information on provider and supplier performance, and to enhance the education and awareness of consumers for evaluating health care services through the development and release of reports based on Medicare enrollment, claims, survey, and assessment data.

Client expense: $13,595,451 · Firm income: Not reported

Government targets: Federal Aviation Administration (FAA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of

H.R. 6111, The Tax Relief and Health Care Act of 2006; all provisions H.R. 6134, Health Opportunity Patient Empowerment Act of 2006; all provisions S. 1418, Wired for Health Care Quality Act; all provisions S. 3585, Health Savings Account Improvement and Expansion Act of 2006; all provisions S. 3900, Medicare Quality Enhancement Act; all provisions Department of Treasury, Final Regulations on Comparable Contributions for Health Savings Accounts; all provisions Department of Health and Human Services, President’s Executive Order on Health Transparency; all provisions 42 Fed. Reg. 14703, Implementation of Regulations; provisions relating to release of Centers for Medicare and Medicaid Services data H.R. 4157, The Health Information Technology Promotion Act of 2005; all provisions H.R. 5262, The Tax Free Health Savings Act; all provisions H.R. 5743, The Health Savings Account Improvement and Expansion Act of 2006; all provisions

Client expense: $5,320,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Council on Environmental Quality (CEQ), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Economic Council (NEC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Trade Representative (USTR)

Medicare; Medicare Advantage; Medicare Advantage Payment Rates; S3900 "Medicare Quality Enhancement Act of 2006"

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE

S. 3701: A bill to determine successful methods to provide protection from catastrophic health expenses for individuals who have exceeded health insurance coverage for uninsured individuals, and for other purposes. S. 3900: A bill to amend title XVIII of the Social Security Act to improve the quality and efficiency of health care, to provide the public with information on provider and supplier performance, and to enhance the education and awareness of consumers for evaluating health care services through the development and release of reports based on Medicare enrollment, claims, survey, and assessment data. Other Matters: Department of Health and Human Services - Centers for Medicare and Medicaid Services, relating to guidance clarifying reimbursement for drugs that can be covered under Parts B and D of Medicare. S.4—Title: A bill to reduce healthcare costs, expand access to affordable healthcare coverage, and improve healthcare and strengthen the healthcare safety net, and for other purposes. S.16—Title: A bill to reduce to the cost of quality health care coverage and improve the availability of health care coverage for all Americans. S.309—Title: A bill to amend the Internal Revenue Code of 1986 to provide for the disposition of unused health benefits in cafeteria plans and flexible spending arrangements. S.544—Title: A bill to amend title IX of the Public Health Service Act to provide for the improvement of patient safety and to reduce the incidence of events that adversely effect patient safety. S.637—Title: A bill to establish a national health program administered by the Office of Personnel Management to offer health benefits plans to individuals who are not Federal employees, and for other purposes. S.1015—Title: A bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. S.1286—Title: A bill to require States to report data on Medicaid beneficiaries who are employed. S.1356—Title: A bill to amend title XVIII of the Social Security Act to provide incentives for the provision of high quality care under the Medicare program. S.1418—A bill to enhance the adoption of a nationwide inter operable health information technology system and to improve the quality and reduce the costs of health care in the United States. S.1932—An original bill to provide for reconciliation pursuant to section 202(a) of the concurrent resolution on the budget for fiscal year 2006, including provisions to include value based purchasing in Medicare. S.1955—A bill to amend title I of the Employee Retirement Security Act of 1974 and the Public Health Service Act to expand health care access and reduce costs through the creation of small business health plans and through modernization of the health insurance marketplace. S.2229—A bill to provide quality, affordable health care for all Americans. S.2510—A bill to establish a national health program administered by the Office of Personnel Management to offer health benefits plans to individuals who are not Federal employees, and for other purposes. S.2772—A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S.3701—A bill to determine successful methods to provide protection from catastrophic health expenses for individuals who have exceeded health insurance coverage for uninsured individuals, and for other purposes. S.3585—A bill to amend the Internal Revenue Code of 1986 to improve and expand the availability of health savings accounts, and for other purposes. H.R.1872—To amend the Internal Revenue Code of 1986 to provide tax incentives for the purchase of qualified health insurance, and for other purposes. H.R.2073—To amend the Internal Revenue Code of 1986 to provide tax subsidies to encourage small employers to offer affordable health coverage to their employees through qualified health pooling arrangements, to encourage the establishment and operation of these arrangements, and for other purposes. H.R.2203—To amend the Internal Revenue Code of 1986 to allow individuals a refundable and advanceable credit against income tax for health insurance costs, to allow employees who elect not to participate in employer subsidized health plans an exclusion from gross income for employer payments in lieu of such participation, and for other purposes. H.R.2234—To authorize the Secretary of Health and Human Services to make health information technology grants, and for other purposes. H.R.2355—To amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. H.R. 4157: To promote a better health information system. H.R.4511—To amend the Internal Revenue Code of 1986 to allow the use of flexible spending and health reimbursement arrangements in combination with health savings accounts, and for other purposes. H.R. 4859: 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. H.R.4832—To amend the Social Security Act to establish an Office of Health Information Technology for the purpose of creating a national interoperable health information infrastructure, to provide loans to health care entities seeking to implement such infrastructure, and to provide exceptions to certain health anti-kickback laws to encourage the dissemination of health information technology. H.R.5262—To amend the Internal Revenue Code of 1986 to provide tax incentives for the payment of premiums for high deductible health plans, and for other purposes. H.R.5586—To amend the Internal Revenue Code of 1986 to allow distributions from health savings accounts to be used for the purchase of non-group coverage under high deductible health insurance. H.R. 5743: To amend the Internal Revenue Code of 1986 to improve and expand the availability of health savings accounts, and for other purposes. H.R. 5864: To provide for innovation in health care through State initiatives that expand coverage and access. H.R. 5886: To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for a AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R. 6134: To amend the Internal Revenue Code of 1986 to expand health coverage through the use of high deductible health plans and to encourage the use of health savings accounts. H.R.525--To amend Title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

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

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

Health Savings Account improvements (H.R. 6111); Health information technology legislation (S. 1418, H.R. 4642, H.R. 4746); Health care transparency legislation (S. 3900).

Client expense: $720,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Energy Regulatory Commission (FERC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR)

Generic Biologics (HR 6257, S 4016) The Lower Priced Drugs Act (S 2300, HR 6022) Release of Medicare Claims Database (Medicare Quality Enhancement Act, S 3900) Medicare Implementation issues Office of Generic Drug funding (HR 5384, FY 2007 Agriculture Appropriations) Transparency of Price and Quality Standards Bioshield/Biodefense legislation (S 1873, HR 5533, S 2564, S 3678) Comparative Effectiveness (HR 5647, S 3708, Labor-HHS FY 2007 Appropriations) Health Information Technology (S 1418, HR 4157) Health Savings Accounts (HR 4511, S 3585, HR 5743, HR 6111)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Council of Economic Advisers (CEA), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Highway Traffic Safety Administration (NHTSA), Natl Security Council (NSC), Natl Transportation Safety Board (NTSB), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Office of Thrift Supervision (OTS), Office of the Comptroller of the Currency (OCC), Overseas Private Investment Corp (OPIC), SENATE, State, Dept of (DOS), Surface Transportation Board (STB), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

S.2229—A bill to provide quality, affordable health care for all Americans. S.2510—A bill to establish a national health program administered by the Office of Personnel Management to offer health benefits plans to individuals who are not Federal employees, and for other purposes. S.2772—A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S.3701—A bill to determine successful methods to provide protection from catastrophic health expenses for individuals who have exceeded health insurance coverage for uninsured individuals, and for other purposes. S.3585—A bill to amend the Internal Revenue Code of 1986 to improve and expand the availability of health savings accounts, and for other purposes. S. 3701: A bill to determine successful methods to provide protection from catastrophic health expenses for individuals who have exceeded health insurance coverage for uninsured individuals, and for other purposes. S. 3900: A bill to amend title XVIII of the Social Security Act to improve the quality and efficiency of health care, to provide the public with information on provider and supplier performance, and to enhance the education and awareness of consumers for evaluating health care services through the development and release of reports based on Medicare enrollment, claims, survey, and assessment data. H.R. 5864: To provide for innovation in health care through State initiatives that expand coverage and access. H.R. 5886: To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for a AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R. 6134: To amend the Internal Revenue Code of 1986 to expand health coverage through the use of high deductible health plans and to encourage the use of health savings accounts. S.4—Title: A bill to reduce healthcare costs, expand access to affordable healthcare coverage, and improve healthcare and strengthen the healthcare safety net, and for other purposes. S.16—Title: A bill to reduce to the cost of quality health care coverage and improve the availability of health care coverage for all Americans. S.306—Title: A bill to prohibit discrimination on the basis of genetic information with respect to health insurance and employment. S.309—Title: A bill to amend the Internal Revenue Code of 1986 to provide for the disposition of unused health benefits in cafeteria plans and flexible spending arrangements. S.544—Title: A bill to amend title IX of the Public Health Service Act to provide for the improvement of patient safety and to reduce the incidence of events that adversely effect patient safety. S.637—Title: A bill to establish a national health program administered by the Office of Personnel Management to offer health benefits plans to individuals who are not Federal employees, and for other purposes. S.1015—Title: A bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. S. 1085: A bill to provide for paid sick leave to ensure that Americans can address their own health needs and the health needs of their families. S.1286—Title: A bill to require States to report data on Medicaid beneficiaries who are employed. S.1356—Title: A bill to amend title XVIII of the Social Security Act to provide incentives for the provision of high quality care under the Medicare program. S.1418—A bill to enhance the adoption of a nationwide inter operable health information technology system and to improve the quality and reduce the costs of health care in the United States. S.1932—An original bill to provide for reconciliation pursuant to section 202(a) of the concurrent resolution on the budget for fiscal year 2006, including provisions to include value based purchasing in Medicare. S.1955—A bill to amend title I of the Employee Retirement Security Act of 1974 and the Public Health Service Act to expand health care access and reduce costs through the creation of small business health plans and through modernization of the health insurance marketplace. entrepreneurs with small businesses with respect to medical care for their employees. H.R.1227—To prohibit discrimination on the basis of genetic information with respect to health insurance and employment. H.R.1872—To amend the Internal Revenue Code of 1986 to provide tax incentives for the purchase of qualified health insurance, and for other purposes. H.R. 1902: To provide for paid sick leave to ensure that Americans can address their own health needs and the health needs of their families. H.R.2071—To amend titles XIX and XXI of the Social Security Act to provide for FamilyCare coverage for parents of enrolled children, and for other purposes. H.R.2073—To amend the Internal Revenue Code of 1986 to provide tax subsidies to encourage small employers to offer affordable health coverage to their employees through qualified health pooling arrangements, to encourage the establishment and operation of these arrangements, and for other purposes. H.R.2203—To amend the Internal Revenue Code of 1986 to allow individuals a refundable and advanceable credit against income tax for health insurance costs, to allow employees who elect not to participate in employer subsidized health plans an exclusion from gross income for employer payments in lieu of such participation, and for other purposes. H.R.2234—To authorize the Secretary of Health and Human Services to make health information technology grants, and for other purposes. H.R.2355—To amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. H.R. 4157: To promote a better health information system. H.R.4511—To amend the Internal Revenue Code of 1986 to allow the use of flexible spending and health reimbursement arrangements in combination with health savings accounts, and for other purposes. H.R. 4859: 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. H.R.4832—To amend the Social Security Act to establish an Office of Health Information Technology for the purpose of creating a national interoperable health information infrastructure, to provide loans to health care entities seeking to implement such infrastructure, and to provide exceptions to certain health anti-kickback laws to encourage the dissemination of health information technology. H.R.5262—To amend the Internal Revenue Code of 1986 to provide tax incentives for the payment of premiums for high deductible health plans, and for other purposes. H.R.5586—To amend the Internal Revenue Code of 1986 to allow distributions from health savings accounts to be used for the purchase of non-group coverage under high deductible health insurance. H.R. 5743: To amend the Internal Revenue Code of 1986 to improve and expand the availability of health savings accounts, and for other purposes. H.R.66—To amend the Internal Revenue Code of 1986 to improve health care choice by providing for the tax deductibility of medical expenses by individuals. H.R.525—To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for

Client expense: Not reported · Firm income: $320,996

Government targets: Equal Employment Opportunity Commission (EEOC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Treasury, Dept of, White House Office

HR. 6111, Tax Relief and Health Care Act of 2006. ***, no specific bill(s), Medicare Reimbursement, Inpatient Prospective Payment System, Gainsharing. HR. 5369. Medicare Clinical Laboratory Fee Schedule Improvement Act of 2006. HR. 3559, Medicare Durable Medical Equipment Access Act of 2005. S. 2022, Remote Monitoring Access Act of 2005. S. 3900, Medicare Quality Enhancement Act of 2006. HR. 5866, Medicare Physician Payment Reform and Quality Improvement Act of 2006. HR. 3617, Medicare Value-Based Purchasing for Physicians' Services. S. 1356, Medicare Value Purchasing Act. S. 3795, Access to Medicare Imaging Act. Please see attached addendum page.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), White House Office

***, no specific bill number(s), Medicare, Medicare Advantage, Medicare Part D. HR. 6111, Tax Relief and Health Care Act of 2006. S. 3900, Medicare Quality Enhancement Act of 2006.

Client expense: Not reported · Firm income: $200,000

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

Medicare; Medicare Advantage; Medicare Advantage Payment Rates; S3900 "Medicare Quality Enhancement Act of 2006"

Client expense: $114,231 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 791/S. 351: The Safe Nursing and Patient Care Act. All provisions related to the prohibition of the use of mandatory overtime. H.R. 1372: The Quality Nursing Care Act. All provisions related to nurse staffing. H.R. 2716/S. 1515: Medicaid Advanced Practice Nurse and Physician Assistants Access Act of 2005. All provisions related to eliminating barriers to APRN practice. CMS Regulation Medicare Prospective Payment System and Consolidated Billing for skilled nursing facilities for FY 2006. All provisions related to certifications and recertifications performed by nurse practitioners and clinical nurse specialists. Centers for Medicare and Medicaid Services proposed rule to alleviate hospitals of overly burdensome regulations. All revisions related to hospital conditions of participation, examinations, authentication of verbal orders, etc. H.R. 3617: Medicare Value - Based Purchasing for Physician Services Act. The Centers for Medicare and Medicaid Services (CMS) issued a final rule that establishes new data collection, posting and record keeping requirements related to staffing in skilled nursing facilities. H.R. 4349: The Patient Safety Act of 2005. All provisions to public disclosure of staffing and performance. H.R. 4293: The Nursing Home Staffing Act of 2005. All provisions related to establishment of minimum requirements for nurse staffing in nursing facilities. Centers for Medicare and Medicaid Services (CMS) Medicare Program Proposed changes to the Hospital Inpatient Prospective payment System and Fiscal Year 2007 rates. Congressional contacts on Medicare reimbursement caps for outpatient therapy services. S. 3900: Medicare Quality Enhancement Act. Congressional contacts on the Medicare SGR as it relates to payments for Part B professional medical services. S. 71: The Registered Nurse Safe Staffing Act. All provisions related to nurse staffing

Client expense: $315,334 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

H.R. 791/S. 351: The Safe Nursing and Patient Care Act. All provisions related to the prohibition of the use of mandatory overtime. H.R. 1372: The Quality Nursing Care Act. All provisions related to nurse staffing. H.R. 2716/S. 1515: Medicaid Advanced Practice Nurse and Physician Assistants Access Act of 2005. All provisions related to eliminating barriers to APRN practice. CMS Regulation Medicare Prospective Payment System and Consolidated Billing for skilled nursing facilities for FY 2006. All provisions related to certifications and recertifications performed by nurse practitioners and clinical nurse specialists. Centers for Medicare and Medicaid Services proposed rule to alleviate hospitals of overly burdensome regulations. All revisions related to hospital conditions of participation, examinations, authentication of verbal orders, etc. H.R. 3617: Medicare Value - Based Purchasing for Physician Services Act. The Centers for Medicare and Medicaid Services (CMS) issued a final rule that establishes new data collection, posting and record keeping requirements related to staffing in skilled nursing facilities. H.R. 4349: The Patient Safety Act of 2005. All provisions to public disclosure of staffing and performance. H.R. 4293: The Nursing Home Staffing Act of 2005. All provisions related to establishment of minimum requirements for nurse staffing in nursing facilities. Centers for Medicare and Medicaid Services (CMS) Medicare Program Proposed changes to the Hospital Inpatient Prospective payment System and Fiscal Year 2007 rates. Congressional contacts on Medicare reimbursement caps for outpatient therapy services. S. 3900: Medicare Quality Enhancement Act. Congressional contacts on the Medicare SGR as it relates to payments for Part B professional medical services. S. 71: The Registered Nurse Safe Staffing Act. All provisions related to nurse staffing

Client expense: $315,334 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

HR 6236 Medicare Long-Term Care Hospital Improvement Act of 2006 To amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. HR 916 Medicare Access to Rehabilitation Services Act of 2005 To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. HR 6408 Tax Relief and Health Care Act of 2006 To amend the Internal Revenue Code of 1986 to extend expiring provisions, and for other purposes. TITLE III--HEALTH SAVINGS ACCOUNTS DIVISION B--MEDICARE AND OTHER HEALTH PROVISIONS TITLE I--MEDICARE IMPROVED QUALITY AND PROVIDER PAYMENTS TITLE II--MEDICARE BENEFICIARY PROTECTIONS TITLE III--MEDICARE PROGRAM INTEGRITY EFFORTS TITLE IV--MEDICAID AND OTHER HEALTH PROVISIONS S 438 Medicare Access to Rehabilitation Services Act of 2005 To amend title XVIII of the Social Security Act to repeal the medicare outpatient rehabilitation therapy caps S1002 Hospital Fair Competition Act of 2005 A bill to amend title XVIII of the Social Security Act to make improvements in payments to hospitals under the medicare program, and for other purposes. S1932 Deficit Reduction Omnibus Reconciliation Act of 2005 An original bill to provide for reconciliation pursuant to section 202(a) of the concurrent resolution on the budget for fiscal year 2006. TITLE VI--COMMITTEE ON FINANCE Subtitle A--Medicaid Subtitle B--Medicare Part E--Value-Based Purchasing S 3609 Physician Pathology Services Continuity Act of 2006 To amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare program. S 3767 Payment Accuracy Improvement Act of 2006 A bill to delay the full implementation of the occupational mix adjustment to the wage index under the Medicare inpatient hospital prospective payment system. S 3900 Medicare Quality Enhancement Act of 2006 To amend title XVIII of the Social Security Act to improve the quality and efficiency of health care, to provide the public with information on provider and supplier performance, and to enhance the education and awareness of consumers for evaluating health care services through the development and release of reports based on Medicare enrollment, claims, survey, and assessment data. HR 4331 Medicaid Access Project through Information Technology (MAP IT) Act of 2005 To provide for a Medicaid demonstration project for chronic disease management.

Client expense: $900,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare; Medicare Advantage; Medicare Advantage Payment Rates; "S3900 Medicare Quality Enhancement Act of 2006"

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Family and Medical Leave Act (FLMA) reform H.R. 6134, to improve health savings accounts ADA accessibility rules H.R. 4175, S. 1418, Health IT bills H.R. 525, Association health plans Long-term healthcare H.R. 1227, Biggert-Slaughter Genetics Bill S. 306, Genetic Information Nondiscrimination Act S. 309, FSA rollover E-health initiatives H.R. 2335, the Health Care Choice Act H.R. 5, the HEALTH Act H.R. 3204, the State High Risk Pool Funding Extension Act S. 544, Patient Safety and Quality Improvement Act Health care gainsharing H.R. 4511, Flex Savings Accounts (Flex HSAs) Act S. 1955, Health Insurance Marketplace Modernization and Affordability Act H.R. 4157, Health Information Technology Promotion Act H.R. 5262, Tax-Free Health Savings Act Health care transparency S. 3900, Medicare Quality Enhancement Act Internet pharmacies/drug importation S. 4, Healthy America Prescription drug safety H.R. 5, Medical liability reform

Client expense: $3,640,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Federal Communications Commission (FCC), 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), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Treasury, Dept of, U.S. Postal Service (USPS), U.S. Trade Representative (USTR), White House Office

S. 124 - Repeal of the Medicare Advantage Stabilization Fund; S. 1356 - Medicare Value Purchasing Act; S. 2255 - Medicare Drug Formulary Protection Act; S. 2260 - Medicare Advantage Funding; S. 3900 - The Medicare Quality Enhancement Act of 2006 HR 3617 - Medicare Value-Based Purchasing for Physicians' Services Act; HR 4297 - Tax Relief Extension Reconciliation Act; HR 4719 - Medicare Advantage Funding; HR 5399 - Medicare Drug Benefit Enrollment Fairness Act;

Client expense: $1,800,000 · Firm income: Not reported

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

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

Medicare Part D Medicare Advantage (S.3900)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1932/HR 4241-Deficit Reduction Act of 2005 (Bills concerned with gainsharing and its implications on patient access to medical devices efficiency standards in pay-for-performance program) HR 5369-Medicare Clinical Laboratory Fee Schedule Improvement Act of 2006 (Bill to improve payments under the Medical clinical laboratory fee schedule) S. 3900-Medicare Quality Enhancement Act of 2006 (Bill to improve quality and efficiency of health care, to provide public with information on provider and supplier performance, and to enhance education and awareness of consumers for evaluating health care services through development and release of reports based on Medicare enrollments, claims, survey, and assessment data) HR 5866-Medicare Physician Payment Reform and Quality Improvement Act of 2006 (Bill to reform physician payment under the Medicare program) HR 3617-Medicare Value-Based Purchasing for Physicians’ Services Act of 2005 (Bill to provide for value-based purchasing in the payment for physicians’ services under the Medicare program) S 1356-Medicare Value Purchasing Act of 2005 (Bill to provide incentives for the provision of high quality care under the Medicare program) S 1002-Hospital Fair Competition Act of 2005 (Bill to make improvements in payments to hospitals under the Medicare program) HR 4297-Tax Relief Extension Reconciliation Act of 2005 S 2020-Tax Relief Act of 2005 (Bills to provide for reconciliation pursuant to section 202(b) of the concurrent resolution on the budget for fiscal year 2006) HR 6063-The Remote Monitoring Access Act of 2006 S 2022-Remote Monitoring Access Act of 2005 (Bills to provide for coverage of remote patient management services for chronic health care conditions under the Medicare program) S 3795/HR 5704-Access to Medicare Imaging Act of 2006 (Bills to provide for a budget-neutral two-year moratorium on certain Medicare physician payment reductions for imaging services) HR 3559-Medicare Durable Medical Equipment Access Act of 2005 (Bill to assure access to durable medical equipment under the Medicare Program) HR 4994-Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2006 (Bill to exempt complex rehabilitation products and assistive technology products from the Medicare competitive acquisition program) S 3920-Medicare Durable Medicare Equipment Access Act of 2006 (Bill to assure access to durable medical equipment under the Medicare Program) HR 3196/S 470-Fair Access to Clinical Trials (FACT) Act (Bills to expand the scope of information required for the data bank on clinical trials) S 3822-Genomics and Personalized Medicine Act of 2006 (Bill to improve access and appropriate utilization of valid, reliable and accurate molecular genetic tests by all populations)

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

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;

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

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

Medicare; Medicare Advantage; S.3900 "Medicare Quality Enhancement Act of 2006"; Medicare Contractor regional contracting process.

Client expense: $280,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

All issues related to Health Care Transparency, S. 3900

Client expense: $380,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE, U.S. Trade Representative (USTR)