Medicare Access to Rehabilitation Services Act of 2005

Home health agency payment limits and patient rehabilitation PPS Medicare and audiology reimbursement issues, including direct access and fee schedule changes Medicare coverage issues for speech-language pathology - including coverage of augmentative communication devices State Licensure equivalency with ASHA certification; CMS's definition of speech-language pathologists and audiologists; role of physician in dysphagia evaluation; local medical review policies - S. 657/H.R. 3795 (SLP Supplier Status - Separating SLP & PT in Outpatient Medicare Statute); Value-based purchasing in the payment for physicians' services under the Medicare Program - H.R. 3617; implementation of CMS therapy caps exception process and documentation of functional progress. RBRVS/Medicare Fee Schedule Medicare Prospective Payment System (PPS) - skilled nursing facilities (student minutes supervision); rehabilitation hospitals; outpatient hospital services Medicare part B $1500 Cap - Repeal on the cap S. 438

Client expense: $2,000,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

H S. 3677 Medicare Independent Living Act, to allow Medicare to cover in-house use wheelchairs, H.R. 916/S. 438, Medicare Access to Rehabilitation, to remove PT caps on Medicare; opposed S. 1955 b/c it would permit exclusion of state insurance mandates, supported all efforts to increase NIH funding; supproted H.R. 3248/S. 1283, Lifespan Respite Act, to provide federal funding for respite care. H.R. 810, Stem Cell Enhancement Act, efforts in make more stem cell lines available for federal funding; S. 1537, to codify the MS VA Centers of Excellence, effort to protect its MS research

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA)

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

HR 709 (Medicare Beneficiary Freedom To Contract Act of 2005) -- impact on podiatrists HR 916, S 438 (Medicare Access to Rehabilitation Services Act of 2005) -- podiatric medical benefits HR 6111 (Tax Relief and Health Care Act of 2006) -- reimbursement for podiatrists HR 6408 (Tax Relief and Health Care Act of 2006) -- impact on practicing podiatric medicine S 1356 (Medicare Value Purchasing Act of 2005) -- impact on practicing podiatric medicine HR 699, S 440 -- patient access to podiatrists Competitive acquisition of durable medical equipment, prosthetics, orthotics, and supplies as required by Public Law No. 108-173 (Medicare Modernization Act of 2003) -- impact on practicing podiatric medicine

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 916/S 438 - Medicare Access to Rehabilitation Services Act, to amend title XVIII of the Social Security Act to repeal caps on Medicare outpatient therapy services; S 3516 - Rural Equity Payment Index Reform Extension Act, to extend the floor onthe work geographic index under the Medicare physician fee schedule; S 3677 - Medicare Independent Living Act, to eliminate the "in the home" restriction for Medicare coverage of devices to enhance the mobility of individuals with functional limitations, impairments, and disabilities; HR 5866 - Medicare Physican Payment Reform and Quality Improvement Act, to reform Medicare payment to health care professionals billing through the Medicare physician fee schedule; HR 3373/S 1405 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act, to extend until two years after passage of the bill the 50% compliance threshold used to determine if a hospital or unit of a hospital is an inpatient rehabilitation facility; HR 3795/S 657 - to amend Title XVIII of the Social Security Act to modify the definition of outpatient speech-language pathology services in order to recognize speech-language pathologists as suppliers under the Medicare program; Payment for physical therapist services under the Medicare physician fee schedule; Medicare skilled nursing facility payment for physical therapist services; Medicare "pay for performance"; Proposed quality standards for suppliers of durable medical equipment. HR 1333/S 647 - Medicare Patient Access to Physical Therapists Act, to amend Title XVIII of the Social Security Act ot authorize physical therapists to evaluate and treat Medicare beneficiaries without requirement of a physician referral;

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

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

Federal Medical Assistance Percentage legislation; HR 1333, S 647: Medicare Patient Access to Physical Therapists Act of 2005; HR 916, S. 438: Medicare Access to Rehabilitation services Act of 2005; S. 1932 budget reconciliation legislation; HR 910, S 401: Medicaid Community Based Attendant Services and Support Act of 2005; S 3705/HR 5834 Protecting Children's Health in Schools Act. SCHIP implementation; Medicare and Medicaid reform; HR 916, S 428: Medicare Adult Day Services Alternative Act of 2005; HR 1443, S 183: Family Opportunity Act; Medicare competitive bidding; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003;

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

Government targets: Agriculture, Dept of (USDA), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, White House Office

S. 1951: CLASS Act; S 3705/HR 5834: Protecting Children's Health in Schools Act. HR 1433, S 183: Family Opportunity Act; Patients' Rights Legislation; HR 916/S 438: Medicare Access to Rehabilitation Services Act of 2005; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003; S. 1932 Budget Reconciliation Legislation; Mental Health Equitable Treatment Act;

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

Government targets: Agriculture, Dept of (USDA), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, White House Office

S. 3912 and H.R. 6132, "Securing Effective and Necessary Individual Outpatient Rehabilitation Services Act of 2006." Extension of therapy caps exceptions process in H.R. 6111, "Tax Relief and Health Care Act of 2006" and S. 3523 All provisions in S. 438 and H.R. 916, "Medicare Access to Rehabilitation Services Act of 2005."

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Provision and coverage of occupational therapy services • HR 1443, Family Opportunity Act of 2005 • S 183, Family Opportunity Act of 2005 Provisions related to parity and inclusion of occupational therapy • HR 1125, Medicare Mental Health Copayment Equity Act of 2005 • HR 1946, Medicare Mental Health Modernization Act of 2005 • S 1152, Medicare Mental Health Copayment Equity Act of • S 927, Medicare Mental Health Modernization Act of 2005 All provisions • HR 1333, Medicare Patient Access to Physical Therapists Act of 2003 • HR 2869, Ending the Medicare Disability Waiting Period Act of 2005 • HR 3373, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 • HR 3022, Medicare Occupational Therapy Coverage Eligibility Act of 2005 • HR 4223, Medicaid Preservation Act of 2005 • HR 916, Medicare Access to Rehabilitation Services Act of 2005 • S 1217, Ending the Medicare Disability Waiting Period Act of 2005 • S 1405, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 • S 1716, Emergency Health Care Relief Act of 2005 • HR 3952, Emergency Health Care Relief Act of 2005 • S 2181, Medicare State Reimbursement Act • S 1951, CLASS Act - Community Living Assistant Service and Supports Act • S 438, Medicare Access to Rehabilitation Services Act of • S 647, Medicare Patient Access to Physical Therapists Act of 2003' • S. 3912, Securing Effective and Necessary Individual Outpatient Rehabilitation Services Act of 2006 • HR 6132, Securing Effective and Necessary Individual Outpatient Rehabilitation Services Act of 2006 Provisions related to occupational therapy services • HR 1381, Medicare Nursing Facility Pay-for-Performance Act of 2005 • HR 2487, Preserving Medicare for All Act of 2005 • S 3963, Access to Physical Medicine & Rehabilitation Services Improvement Act of 2006 Inclusion of occupational therapy and rehabilitation services • HR 2629, Positive Aging Act of 2005 • S 1116, Positive Aging Act of 2005 • HR 2807, Medicare Telehealth Enhancement Act of 2005 • S 1225, Access to Affordable Health Care Act • S 1503, Healthy America Act of 2005 • S 4, Healthy America Act of 2005 Provisions related to Medicare coverage of occupational therapy services, training and education under Title VII of the Public Health Service Act, and funding for IDEA • HR 5647, Making Appropriations for Depts of Labor, Health and Human Svcs. And Education, and related agencies for year ending Sept. 30, 2007 • S 3708, Making Appropriations for Depts of Labor,Health and Human Svcs and Education and related agencies for year ending Sept 30 2007 Inclusion of occupational therapy practitioners • HR 3074, Quality Healthcare Coalition Act of 2005 Provisions related to reimbursement for occupational therapy services • HR 3617, Medicare Value Based Purchasing for Physician's Services Act of 2005 • HR 4520, Medicare Physician Payment Reform Act of 2005 Provisions related to occupational therapy and rehabilitation services • S 1356, Medicare Value Purchasing Act of 2005 • S 1440, Pulmonary and Cardiac Rehabilitation Act of 2005 • HR 4824, Pulmonary and Cardiac Rehabilitation Act of 2005 • S 1580, A bill to improve the health of minority individuals • HR 3561, A bill to improve the health of minority individuals • S 2022, Remote Monitoring Access Act of 2005 • S 1909, Medicare Telehealth Enhancement Act All provisions, especially as related to occupational therapy services • HR 898, Stroke Treatment and Ongoing Prevention Act • S 1064, Stroke Treatment and Ongoing Prevention Act Provisions related to extension of therapy caps exceptions process: • HR 6111, Tax Relief and Health Care Act of 2006 • S 3523, Tax Relief and Health Care Act of 2006 Issues regarding 5-year review and SGR fix - no bills related to this topic.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 438 - Medicare Access to Rehabilitation Services Act of 2005 S 345 - Medicare Prescription Drug Savings and Choice Act of 2005 S 338 - Bipartisan Commission on Medicaid Act of 2005 HR 985 - Bipartisan Commission on Medicaid Act of 2005 S 18 - Meeting our Responsibility to Medicare Beneficiaries Act of 2005 HR 916 - Medicare Access to Rehabilitation Services Act of 2005 HR 752 - Medicare Prescription Drug Savings and Choice Act of 2005 Citizenship Requirement for Medicaid Coverage Asset Transfer Requirement for Long Term Care Medicaid Coverage

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, State, Dept of (DOS), Treasury, Dept of, White House Office

H.R.147 H.R.303 H.R.602 H.R.783 H.R.916 H.R.968 H.R.994 H.R.999 H.R.1366 H.R.2046 H.R.2076 H.R.2131 H.R.2356 H.R.4747 H.R.4949 H.R.5122 H.R.5631 H.R.5866 Improvements in the Military Retirement System and enhance Military Health Care Programs and Benefits. S. 11 S.407 S.438 S.484 S. 558 S.619 S.1081 S.1932 S.2385 S.2530 S.2617 S.2766

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

Government targets: Air Force, Dept of, Army, Dept of (Other), Congressional Budget Office (CBO), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Navy, Dept of, Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Veterans Affairs, Dept of (VA)

reducing subsidies to private Medicare Part D plans; 4) S. 3647 pertaining to Medicare Part D's coverage gap; 5) H.R. 5969 pertaining to Part D’s low-income subsidy and asset test; 6) S. 334, H.R. 700, H.R. 328, S. 109, S. 184, H.R. 753, H.R. 5441 pertaining to restrictions placed on the commercial and private importation of prescription drugs; 7) H.R. 376, S. 445 authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices with manufacturers; 8) H.R. 916, S. 438, H.R. 6111 pertaining to the Medicare Part B outpatient rehabilitation services therapy caps; 9) H.R. 2072, S. 3747: provisions pertaining to access to Medicare for individuals ages 55 to 65 and authorizing a refundable and “advanceable” credit against income tax for premium payments; 10) S. 1152, H.R. 1125 amending Medicare’s coinsurance for outpatient mental health care; 11) S. 1335 to preserve Medicare beneficiaries’ appeal rights; 12) S. 347, H.R. 2058, S. 570 providing Medicare beneficiaries with a free physician office visit to discuss end-of-life care in conjunction with preparing advance directives; 13) H.R. 5147 eliminating Medicare Part B premium means-testing; 14) S. 1889, H.R. 4122, H.R. 5552, S. 3491, H.R. 3282, H.R. 2470, S. 1155, S. 3521: provisions pertaining to the creation of sunset and/or entitlement commissions affecting Medicare and the 45% Medicare funding cap; 15) encouraging the Secretary of Health and Human Services to use his demonstration authority to waive Medicare Part D’s late enrollment penalty for beneficiaries affected by Hurricane Rita (no resolution or bill was pending). Medicaid. 1) H.R. 1229, S. 489 limiting the duration of federal consent decrees to which states and local governments are parties; 2) P.L. 109-171: provisions affecting proof of citizenship requirements for continued Medicaid eligibility; 3) S. 1889, H.R. 4122, H.R. 5552, S. 3491, H.R. 3282, H.R. 5766, H.R. 2470, S. 1155, S. 3521: provisions pertaining to the creation of sunset and/or entitlement commissions affecting Medicaid. 1) S. 345, S. 873, H.R. 752, S. 2342 creating a Medicare-operated Part D benefit with negotiated prescription drug prices; 2) H.R. 3861, H.R. 5969, S. 1841, S. 3654 extending/waiving the late enrollment penalty for Part D; 3) S. 1589, H.R. 6111 eliminating/

Client expense: $4,580,000 · Firm income: Not reported

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

S.1049, Covering Kids Act of 2005, Health care issues. H.R.534/ S.354, Health Act of 2005, Health care issues. H.R.215/S.473, Reinvestment Act of 2005, Health care issues. H.R.3373/S.1405, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005, Health care issues. H.R.916/S.438, Medicare Access to Rehabilitation Services Act of 2005, Heal H.R.2350/S.933, Rural Community Hospital Assistance Act of 2005, Health care issues. S.544, Patient Safety and Quality Improvement Act of 2005, health care issues. H.R.1872/S.978, Health coverage for the Uninsured Act of 2005, Health care issues.

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

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

HR 699, S 440, S 1932, HR 4241, H.Res.640 (Medicaid definition of physician and Deficit Reduction Omnibus Reconciliation Act of 2005) -- patient access to podiatrists HR 2356, S 1081 , S 1574 (Preserving Patient Access to Physicians Act of 2005 and Affordable Access to Medicare Providers Act of 2005) -- reimbursement for podiatrists HR 709 (Medicare Beneficiary Freedom To Contract Act of 2005) -- impact on podiatrists HR 916, S 438 (Medicare Access to Rehabilitation Services Act of 2005) -- expand podiatry benefits S 1356 (Medicare Value Purchasing Act of 2005) -- impact on practicing podiatric medicine

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

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

HR 1166, Long Term Care Quality Improvement Act - support HR 1981, Medicare Adult Day Care Services Act - support HR 916/S 438, repeal Medicare therapy caps - support HR 3437, reform federal survey and certification process for nursing homes - support HR 2807, Medicare Telehealth Enhancement Act - support

Client expense: $156,891 · Firm income: Not reported

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

RBRVS/Medicare Fee Schedule Medicare Prospective Payment System (PPS) – skilled nursing facilities (student minutes supervision); rehabilitation hospitals; outpatient hospital services Medicare Part B $1,500 Cap – Repeal on the cap S. 438 Home health agency payment limits and patient rehab PPS Medicare and audiology Medicare coverage issues for speech-language pathology – including coverage of augmentative communication devices State Licensure equivalency with ASHA certification; CMS’s definition of speech-language pathologists and audiologists; role of physician in dysphagia evaluation; local medical review policies

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE