Part D Equity for Low-Income Seniors Act of 2007

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); H.R. 5683: GAO Act (provisions relating to access to Medicare part C/part D data) (Davis); H.R. 5998: Protecting Children's Health Coverage Act (Pallone); H.R. 6331: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) (Rangel-Dingell); H.R. 6388: GAO Improvement Act (provisions relating to access to Medicare part C/part D data) (Waxman); H.R. 6359: Medicare Beneficiary Protection Act (Biggert); H.R. 6365: Medicare Special Needs Plans Extension and Amendments Act (Kind); H.R. 7077: QI Program Supplemental Funding Act (Dingell) (provisions relating to cost sharing assistance for low-income Medicare beneficiaries); H.R. 7197: Medicare Advantage Funding (Gonzalez) (provisions relating to limiting increases in Medicare Advantage payment rates); H.Res. 1368 (provisions relating to Medicare Funding Warning); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1589: Drug Rebate Equalization Act (Bingaman) (provisions relating to Medicaid drug rebates); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2819: Economic Recovery in Health Care Act (provisions relating to Medicaid funding) (Rockefeller); S. 3101: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) (Baucus); S. 3560: QI Program Supplemental Funding Act (Baucus) (provisions relating to cost sharing assistance for low-income Medicare beneficiaries); S. 3604: Emergency Supplemental Appropriations Act (provisions relating to Medicaid FMAP); S. 3656: Preserving Access to Healthcare Act (Schumer) (provisions relating to Medicare and Medicaid regulation); S. 3869: Economic Stimulus (Reid) (provisions relating to Medicaid FMAP and Medicaidd MCO provider taxes); S. 3710: Medicare Early Access Act (Rockefeller) (provisions relating to Medicare "buy-in" option); and S.J.Res. 44 (provisions relating to blocking implementation of SCHIP requirements). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including audit and encounter data issues), bidding and payment issues (including MA coding intensity, Part D reinsurance, low income subsidies, application process, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality meaasures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration issues for Special Needs Plans (SNPs); Federal premption of State authority over MA and Part D plans, 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 and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting inititiative; issues relating to 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, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; 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 health information technology standards and policies.

Client expense: $2,240,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), 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

S 2337/HR 3363 Long-Term Care Affordability and Security Act - Discussed consumer protections for LTC insurance. S 1070/HR 1783 Elder Justice Act/S 1577 Patient Safety and Abuse Prevention Act of 2007 - Support for both pieces of legislation, strategy for how they might both move forward next year. S 3327/HR 7212 - Empowered at Home Act - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid and other improvements to bill. Also lobbied in support of the bill. HR 7110/S 3604 Job Creation and Unemployment Relief Act - Lobbied for FMAP funding. HR 5613 Protecting the Medicaid Safety Net Act of 2008 - Supported this legislation, particularly provisions related to placing a moratorium on seven harmful Medicaid regulations. Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries, and promote e-prescriptions in medicare (no bill number). S 2408/HR 4296 Medicare Electronic Medication and Safety Protection (E-Meds) Act of 2007- Supported provisions related to requiring e-prescribing in Medicare Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641 Nursing Home Transparency and Improvement Act and HR 7128 Nursing Home Transparency and Quality of Care Improvement Act - Discussed the bill and provided suggestions for changes to the bill, nursing home quality and proposed five star rating system cms; poor performing nursing homes, family caregiving initiative, nursing home compliance guidelines, Home Health CAHPS, LTC Partnership Program (under Medicaid data reporting requirements), LTC Quality Alliance. To build support and obtain sponsors for Medicaid Family Caregiver Assessment Demonstration proposal (no bill number). Discussion and input on legislation to improve the health/LTC workforce and support family caregivers (no bill number). Advance directives and end-of-life care, education of the public about these issues, portability, and other issues relating to advance directives (no bill number). HR 7114/S3613 Independence at Home Act/Chronic Care Coordination - Lobbied on and support for legislation to provide chronic care coordination services to certain Medicare beneficiaries. S 3101/HR 6331 Medicare Improvements for Patients and Providers Act of 2008 - Discussed implementation to help improve Medicare. Lobbied for appeal notices for Medicare beneficiaries in Medicare Advantage plans (no bill number). S 1102 Part D Equity for Low-Income Services - Lobbied for legislation to increase Medicare Part D LIS. HR 1536 Prescription Coverage Now Act - Lobbied for legislation to increase Medicare Part D LIS asset limits. HR 6033 - Discussed provisions of Home-Based Health Services Job Training and Caregiving Act and ways to improve bill.

Client expense: $6,870,000 · Firm income: Not reported

Government targets: Administration on Aging, Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Reserve System, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

Medicare Advantage program - Proposed legislation concerning this issue. Medicare/Medicaid issues - HR 4, Medicare Prescription Drug Price Negotiation Act of 2007; S 3, Medicare Prescription Drug Price Negotiation Act of 2007; S 1102, Part D Equity for Low-Income Seniors Act of 2007; S 1103, Helping Fill the Medicare Rx Gap Act of 2007; S 1107, Home and Community Services Copayment Equity Act of 2007; S 1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007; HR 2945, Medicare Advantage Truth in Advertising Act of 2007; S 799, Community Choice Act of 2007; S 1544, Medicare Quality Enhancement Act of 2007; S 1507, Access to Medicare Data Act of 2007; S 1827, Pharmacist Access and Recognition in Medicare (PhARM) Act of 2007; HR 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007; HR 3061, Medicare Part D Drug Class Protection Act of 2007; HR 3162, Children's Health and Medicare Protection Act of 2007; HR 976, Children's Health Insurance Program Reauthorization Act of 2007; S 1893, Children's Health Insurance Program Reauthorization Act of 2007; S 1954, Pharmacy Access Improvement (PhAIm) Act of 2007; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; S 2219, Medicare Prescription Drug Savings and Choice Act of 2007; HR 3932, Medicare Prescription Drug Savings and Choice Act of 2007; S 2408, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; HR 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; S 1200, Indian Health Care Improvement Act Amendments of 2008; HR 5480, Medicare Funding Warning Response Act of 2008; S 2662, Medicare Funding Warning Response Act of 2008; HR 5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; HR 6388, Government Accountability Office Improvement Act of 2008; HR 5998, Fair and Justifiable Credit Card Interest Rate Act of 2008; S 2819, Economic Recovery in Health Care Act of 2008; HR 6359, Medicare Beneficiary Protection Act of 2008; HR 6365, Medicare Special Needs Plans Extension and Amendments Act of 2008; HR 5613, Protecting the Medicaid Safety Net Act of 2008; S 2620, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid program; HR 5683, Government Accountability Office Act of 2008; HR 7110, Job Creation and Unemployment Relief Act of 2008; S 3560, QI Program Supplemental Funding Act of 2008; HR 7077, QI Program Supplemental Funding Act of 2008; S 3604, Emergency Supplemental; HR 7197, To amend part C of title XVIII of the Social Security Act to limit increases in Medicare Advantage payment rates; S 3656, Preserving Access to Healthcare (PATH) Act of 2008; S 3689, Economic Stimulus; S 3710, Medicare Early Access Act of 2008; S 3101, Medicare Improvements for Patients and Providers Act of 2008.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare/General. H.R. 205, H.R. 748, H.R. 1218, H.R. 1277, H.R. 1310, H.R. 1521, H.R. 2009, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025, H.R. 3061, H.R. 3162, H.R. 3932, H.R. 6331, S. 137, S. 250, S. 450, S. 706, S. 1887, S. 2089, S. 2115, S. 2219, S. 3101: provisions relating to enrollment periods and the late enrollment penalty, physician reimbursement rates, creating a Medicare-operated prescription drug plan, drug price negotiations, Medicare beneficiary improvements, repealing cost containment mandates, Medicare Advantage payments, Medicare Advantage stabilization fund, and comparative cost adjustment demonstration projects under the Medicare Modernization Act, therapy caps, liberalizing asset test limits, reducing the Part D benefit gap and guaranteeing prescription drug benefits. Medicare/Prescription Drug Price Negotiation. H.R. 4, H.R. 118, H.R. 5317, S. 3, S. 273: provisions pertaining to the negotiation of prescription drug prices under Medicare Part D. Medicare/Medicare Advantage. H.R. 2945: provision to provide beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. Medicare/Importation of Prescription Drugs. S. 242, H.R. 380, S.Amdt. 4299: provisions pertaining to the importation of prescription drugs. Medicare/Outpatient Psychiatric Services. H.R. 1571, H.R. 1663, H.R. 4897, S. 1715, S. 1854: provisions to eliminate discriminatory copayment rates for outpatient psychiatric services under Medicare Part B. Medicare/Geriatric Assessments. H.R. 2244, S. 1340: provisions to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. Medicare/Generic Drugs Market Exclusivity. H.R. 1432, H.R. 1902, S. 316, S. 1088: pertaining to market exclusivity for generic drugs. Medicare/Prescription Drug Benefits for Low Income Beneficiaries. H.R. 470, H.R. 932, H.R. 1536, H.R. 2058, H.R. 3127, S. 1102, S. 1103, S. 1107, S. 1108, S. 2101: provisions affecting prescription drug benefits for low-income beneficiaries under Medicare Parts B and D. Medicare/Part B Late Enrollment. H.R. 2591: provision limiting the penalty for late enrollment under Medicare Part B. Medicare/Marketing. H.R. 2307, H.R. 4790, S. 1883, S. 2687: provisions relating to the marketing of Medicare Advantage and Medicare Part D plans. Medicare/Health Care Vouchers. H.R. 749: provision to establish health care vouchers for seniors. Medicare/Medicare Savings Accounts. H.R. 2639, S. 173, S. 1019: provisions pertaining to Medicare Savings Accounts. Medicare/End-of-Life Planning. S. 464, S. 465, S. 466: pertaining to advance directives and end-of-life planning. Medicare/Means-testing. H.R. 4295, H.R. 4330, S. 2414, S.Amdt. 4240: pertaining to means-testing of Medicare Part D. Medicare/Presidents Funding Warning. H.R. 5480, S. 2662: proposals responding to the Presidents Medicare funding warning. H. Res. 1368, to suspend section 803 of the Medicare Modernization Act of 2003 (known as the Medicare trigger") for the remainder of the 110th Congress. Medicare/24-month Waiting Period. H.R.154, S. 2101: provisions phasing out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicaid/Federal Match. H.R. 5140: provisions pertaining to temporary increases in the federal Medicaid match. Medicaid/Targeted Case Management. Targeted Case Management: interim final rule to implement Section 6052 of the Deficit Medicaid/Targeted Case Management (continued). Reduction Act.

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3162, Children's Health & Medicare Protection Act of 2007 (Medicare Payment/Reimbursement Reform); S.1218/HR 2034, Medicare for All Act (Medicare "buy-in"); S. 130/HR 1990, Medicare Cost Contract Extension & Retirement Act of 2007 (private sector role in Medicare); S 3/HR 4, Medicare Prescription Drug Price Negotiation Act of 2007 (Government Negotiation of Medicare Drug Prices); S 1102, Part D Equity for Low Income Seniors Act of 2007 (Special benefits for low income seniors); HR 1663, Medicare Mental Health Modernization Act of 2007 (Medicare Mental Health Parity); HR 976, Children's Health Insurance Program Reauthorization Act of 2007 (SHIP Extension and Expansion); HR 2184, Enhanced Health Care Value for All Act of 2007 (Comparative Effectiveness Research Institute; HR 971, Community Pharmacy Fairness Act of 2007 (Medicare Pharmacist Antitrust Exemption), HR 4327, Medicare Chronic Care Practice Network (Establish a Medicare Chronic Care Practice Research Network to develop and evaluate evidence based chronic care management for Medicare beneficiaries); HR 1193, Kidney Care Quality and Education Act of 2007 (Modernize and improve the Medicare ESRD program); HR 6331, Electronic Prescription in Medicare; HR 6331, Medicare Improvements Act of 2008 (dealing with physician reimbursements and Medicare Advantage funding cuts); H. Res. 1368, Medicare "trigger" to warn against funding problem.

Client expense: $517,594 · Firm income: Not reported

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

Medicare Advantage - HR 6331, Medicare Improvements for Patients and Providers Act of 2008; Proposed legislation re this issue. Medigap insurance market issues - Proposed legislation re these issues. Medicare/Medicaid issues - S 706, To amend title XVIII of the Social Security Act to repeal the MA Regional Plan Stabilization Fund; S 130, Medicare Cost Contract Extension and Refinement Act of 2007; HR 1990, Medicare Cost Contract Extension and Refinement Act of 2007; HR 4, Medicare Prescription Drug Price Negotiation Act of 2007; S 3, Medicare Prescription Drug Price Negotiation Act of 2007; S 1102, Part D Equity for Low-Income Seniors Act of 2007; S 1103, Helping Fill the Medicare Rx Gap Act of 2007; S 1107, Home and Community Services Copayment Equity Act of 2007; S 1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007; HR 2945, Medicare Advantage Truth in Advertising Act of 2007; S 799, Community Choice Act of 2007; S 1544, Medicare Quality Enhancement Act of 2007; S 1507, Access to Medicare Data Act of 2007; S 1827, Pharmacist Access and Recognition in Medicare (PhARM) Act of 2007; HR 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007; HR 3061, Medicare Part D Drug Class Protection Act of 2007; HR 3162, Children's Health and Medicare Protection Act of 2007; HR 976, Children's Health Insurance Program Reauthorization Act of 2007; S 1893, Children's Health Insurance Program Reauthorization Act of 2007; S 1954, Pharmacy Access Improvement (PhAIm) Act of 2007; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; S 2219, Medicare Prescription Drug Savings and Choice Act of 2007; HR 3932, Medicare Prescription Drug Savings and Choice Act of 2007; S 2408, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; HR 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; S 1200, Indian Health Care Improvement Act Amendments of 2008; HR 5480, Medicare Funding Warning Response Act of 2008; S 2662, Medicare Funding Warning Response Act of 2008; HR 5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; HR 6388, Government Accountability Office Improvement Act of 2008; HR 5998, Fair and Justifiable Credit Card Interest Rate Act of 2008; S 2819, Economic Recovery in Health Care Act of 2008; HR 6359, Medicare Beneficiary Protection Act of 2008; HR 6365, Medicare Special Needs Plans Extension and Amendments Act of 2008; HR 5613, Protecting the Medicaid Safety Net Act of 2008; S 2620, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid program; S 3101, Medicare Improvements for Patients and Providers Act of 2008; HR 5683, Government Accountability Office Act of 2008; HR 7110, Job Creation and Unemployment Relief Act of 2008; S 3560, QI Program Supplemental Funding Act of 2008; HR 7077, QI Program Supplemental Funding Act of 2008; SJRes 44, blocking implementation of SCHIP; HRes 1368, Resolved, That section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 shall not apply during the remainder of the 110th Congress; S 3604, Emergency Supplemental.

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

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

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); H.R. 5683: GAO Act (provisions relating to access to Medicare part C/part D data) (Davis); H.R. 5998: Protecting Children's Health Coverage Act (Pallone); H.R. 6331: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) (Rangel-Dingell); H.R. 6388: GAO Improvement Act (provisions relating to access to Medicare part C/part D data) (Waxman); H.R. 6359: Medicare Beneficiary Protection Act (Biggert); H.R. 6365: Medicare Special Needs Plans Extension and Amendments Act (Kind); H.R. 7077: QI Program Supplemental Funding Act (Dingell) (provisions relating to cost sharing assistance for low-income Medicare beneficiaries); H.Res. 1368 (provisions relating to Medicare Funding Warning); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2819: Economic Recovery in Health Care Act (provisions relating to Medicaid funding) (Rockefeller); S. 3101: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) (Baucus); S. 3560: QI Program Supplemental Funding Act (Baucus) (provisions relating to cost sharing assistance for low-income Medicare beneficiaries); S. 3604: Emergency Supplemental Appropriations Act (provisions relating to Medicaid FMAP); and S.J.Res. 44 (provisions relating to blocking implementation of SCHIP requirements). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including audit and encounter data issues) bidding and payment issues (including MA coding intensity, Part D reinsurance, low income subsidies, application process, and audits), application process, and audits, benefit design rules, SSA and CMS premium withhold processing issues, systems issues affecting enrollment and disenrollment processing, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration issues for Special Needs Plans (SNPs); Federal premption of State authority over MA and Part D plans, 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; physician quality reporting inititiative; issues relating to 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, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; 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 health information technology standards and policies.

Client expense: $1,630,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), 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

S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 H.R.1459 To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S. 1107 Home and Community Services Copayment Equity Act of 2007 S. 1102 Part D Equity for Low-Income Seniors Act of 2007 S.2641 Nursing Home Transparency and Improvement Act of 2008 H.R.5799 Nursing Home Transparency and Improvement Act of 2008 H.R.7128 Nursing Home Transparency and Quality of Care Improvement Act of 2008

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3162, Children's Health & Medicare Protection Act of 2007 (Medicare Payment/Reimbursement Reform); S.1218/HR 2034, Medicare for All Act (Medicare "buy-in"); S. 130/HR 1990, Medicare Cost Contract Extension & Retirement Act of 2007 (private sector role in Medicare); S 3/HR 4, Medicare Prescription Drug Price Negotiation Act of 2007 (Government Negotiation of Medicare Drug Prices); S 1102, Part D Equity for Low Income Seniors Act of 2007 (Special benefits for low income seniors); HR 1663, Medicare Mental Health Modernization Act of 2007 (Medicare Mental Health Parity); HR 976, Children's Health Insurance Program Reauthorization Act of 2007 (SHIP Extension and Expansion); HR 2184, Enhanced Health Care Value for All Act of 2007 (Comparative Effectiveness Research Institute; HR 971, Community Pharmacy Fairness Act of 2007 (Medicare Pharmacist Antitrust Exemption), HR 4327, Medicare Chronic Care Practice Network (Establish a Medicare Chronic Care Practice Research Network to develop and evaluate evidence based chronic care management for Medicare beneficiaries); HR 1193, Kidney Care Quality and Education Act of 2007 (Modernize and improve the Medicare ESRD program); HR 6331, Electronic Prescription in Medicare; HR 6331, Medicare Improvements Act of 2008 (dealing with physician reimbursements and Medicare Advantage funding cuts); H. Res. 1368, Medicare "trigger" to warn against funding problem.

Client expense: $452,449 · Firm income: Not reported

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

S 2337/HR 3363 - Discussion of and support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070/HR 1783 Elder Justice Act/S 1577 Patient Safety and Abuse Prevention Act of 2007 - Support for both pieces of legislation, strategy for how they might both move forward this year, bill markup, background for score on S.1577. S 2708 Caring for an Aging America Act of 2008 - Provisions related to increasing the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. S 3230 Empowered at Home Act - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. HR 7110/S 3604 Job Creation and Unemployment Relief Act - Lobbied for FMAP funding. HR 5613 Protecting the Medicaid Safety Net Act of 2008 - Supported this legislation, particularly provisions related to placing a moratorium on seven harmful Medicaid regulations. HR 6331 Medicare Improvements for Patients and Providers Act - Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries, and promote e-prescriptions in medicare. S 2408/HR 4296 Medicare Electronic Medication and Safety Protection (E-Meds) Act of 2007- Supported provisions related to requiring e-prescribing in Medicare Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641 Nursing Home Transparency and Improvement Act - Lobbied in support of the bill and to increase co-sponsors; criminal background checks for LTC employees; nursing home quality and proposed five star rating system cms; poor performing nursing homes, family caregiving initiative, nursing home compliance guidelines, Home Health CAHPS, LTC Partnership Program (under Medicaid data reporting requirements), status of Nursing Home Value Based Purchasing Demonstration, Prepare to Care for use in innovative employer caregiving programs satellite broadcast, LTC Quality Alliance. HR 2642 - Lobbied for inclusion of Medicaid Regulation Moratoriam in Military Construction and Veterans Affairs Appropriations Act of 2008, and on supplemental appropriations bill. To build support and obtain sponsors for Medicaid Family Caregiver Assessment Demonstration proposal (no Bill). S 2838/HR 6126 - Lobbied to support the Fairness in Nursing Home Arbitration Act and oppose amendments to weaken the bill. Discussion and input on legislation to improve the health/LTC workforce and support family caregivers (no bill). Advance directives and end-of-life care, education of the public about these issues, portability, and other issues relating to advance directives (no bill). S 1577- Support for Patient Safety and Abuse Prevention Act (S 1577) and marking up the bill; provided feedback and in testimony. HR 7114/S3613 Independence at Home Act/Chronic Care Coordination - Feedback on and support for legislation to provide chronic care coordination services to certain Medicare beneficiaries. S 1102 Part D Equity for Low-Income Seniors Act of 2007- Support for Medicare premium protection and modifications to Medicare Savings Programs/Part D Low-Income Subsidy. S. 3118 Preserving Access to Medicare Act - Lobbied in opposition to Grassley-McConnell bill - All provisions related to beneficiary access and Medicare improvements, including e-prescribing. S 3101- Urged support of the Medicare Improvements for Patients and Providers Act of 2008 to help improve Medicare. Green Houses and culture change in LTC facilities, person centered care and medical homes - testimony and input on draft bill - no bill number. Lobbied for appeal notices for Medicare beneficiaries in Medicare Advantage plans (no bill). S 1102 Part D Equity for Low-Income Services - Lobbied for legislation to increase Medicare Part D LIS. HR 1536 Prescription Coverage Now Act - Lobbied for legislation to increase Medicare Part D LIS asset limits. HR 5702 End-of-Life Care Advance Directive Promotion Act - Discussed ideas for end-of-life care legislation and how to help ensure patient wishes are respected; Advance Directive Promotion Act. Provided feedback on draft legislation regarding physician orders for life sustaining treatment. S.334 - Discussed long-term care broadly and including it in health care reform, including the Healthy Americans Act. Discussed voting in LTC facilities, such as nursing homes, current status and law on the issue (no bill). S 3327 - Provided input and support for the Empowered at Home Act to make improvements in Medicaid HCBS; LTC insurance tax incentives and consumer protection improvements and a caregiver tax credit. Invitations and information about a solutions forum on balancing of state LTC systems. HR 3363/S 2337 - Discussed consumer protections for LTC insurance, premium increases and claims denials, support for family caregivers including assessment, consumer complaints and support for the LTC Affordability and Security Act. HR 6033 - Discussed provisions of Home-Based Health Services Job Training and Caregiving Act. H.Con.Res 133 - Provided input on and support for new LTC Awareness Week resolution. LTC - General discussion of LTC, home and community based services, family caregiving, chronic care, workforce, quality and financing options.(no bill) CMS - Lobbied on the Medicare Medical Home Demo implementation.

Client expense: $7,330,000 · Firm income: Not reported

Government targets: Administration on Aging, Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Reserve System, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

Medicare/General. H.R. 205, H.R. 748, H.R. 1218, H.R. 1277, H.R. 1310, H.R. 1521, H.R. 2009, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025, H.R. 3061, H.R. 3162, H.R. 3932, H.R. 6331, S. 137, S. 250, S. 450, S. 706, S. 1887, S. 2089, S. 2115, S. 2219, S. 3101: Medicare/General (continued). provisions relating to enrollment periods and the late enrollment penalty, physician reimbursement rates, creating a Medicare-operated prescription drug plan, drug price negotiations, Medicare beneficiary improvements, repealing cost containment mandates, Medicare Advantage payments, Medicare Advantage stabilization fund, and comparative cost adjustment demonstration projects under the Medicare Modernization Act, therapy caps, liberalizing asset test limits, reducing the Part D benefit gap and guaranteeing prescription drug benefits. Medicare/Prescription Drug Price Negotiation. H.R. 4, H.R. 118, H.R. 5317, S. 3, S. 273: provisions pertaining to the negotiation of prescription drug prices under Medicare Part D. Medicare/Medicare Advantage. H.R. 2945: provision to provide beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. Medicare/Importation of Prescription Drugs. S. 242, H.R. 380, S.Amdt. 4299: provisions pertaining to the importation of prescription drugs. Medicare/Outpatient Psychiatric Services. H.R. 1571, H.R. 1663, H.R. 4897, S. 1715, S. 1854: provisions to eliminate discriminatory copayment rates for outpatient psychiatric services under Medicare Part B. Medicare/Geriatric Assessments. H.R. 2244, S. 1340: provisions to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. Medicare/Generic Drugs Market Exclusivity. H.R. 1432, H.R. 1902, S. 316, S. 1088: pertaining to market exclusivity for generic drugs. Medicare/Prescription Drug Benefits for Low Income Beneficiaries. H.R. 470, H.R. 932, H.R. 1536, H.R. 2058, H.R. 3127, S. 1102, S. 1103, S. 1107, S. 1108, S. 2101: provisions affecting prescription drug benefits for low-income beneficiaries under Medicare Parts B and D. Medicare/Part B Late Enrollment. H.R. 2591: provision limiting the penalty for late enrollment under Medicare Part B. Medicare/Marketing. H.R. 2307, H.R. 4790, S. 1883, S. 2687: provisions relating to the marketing of Medicare Advantage and Medicare Part D plans. Medicare/Health Care Vouchers. H.R. 749: provision to establish health care vouchers for seniors. Medicare/Medicare Savings Accounts. H.R. 2639, S. 173, S. 1019: provisions pertaining to Medicare Savings Accounts. Medicare/End-of-Life Planning. S. 464, S. 465, S. 466: pertaining to advance directives and end-of-life planning. Medicare/Means-testing. H.R. 4295, H.R. 4330, S. 2414, S.Amdt. 4240: pertaining to means-testing of Medicare Part D. Medicare/Presidents Funding Warning. H.R. 5480, S. 2662: proposals responding to the Presidents Medicare funding warning. H. Res. 1368, to suspend section 803 of the Medicare Modernization Act of 2003 (known as the Medicare trigger") for the remainder of the 110th Congress. Medicare/24-month Waiting Period. H.R.154, S. 2101: provisions phasing out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Identity Theft Prevention. H.R. 6600, provisions related to removal of Social Security numbers from Medicare cards. Medicaid/Federal Match. H.R. 5140: provisions pertaining to temporary increases in the federal Medicaid match. Medicaid/Targeted Case Management. Targeted Case Management: interim final rule to implement Section 6052 of the Deficit Reduction Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel); H.R. 1535: Children's Health First Act (Dingell); H.R. 1663: Medicare Mental Health Modernization Act (Stark) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2147: Healthy Kids Act (Emanuel); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 2642: Supplemental Appropriations Act (provisions relating to moratoria on Medicaid regulations); H.R. 2842: Childrens Health Protection Act (Schwartz); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3195: ADA Amendments Act (Hoyer); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5550: Coverage for Young Adult Dependents of Federal Employees (Davis); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); H.R. 5683: GAO Act (provisions relating to access to Medicare part C/part D data) (Davis); H.R. 5781: Federal Employees Paid Parental Leave Act (Maloney); H.R. 5840: Insurance Information Act (Kanjorski); H.R. 5918: Small Business Health Options Program Act (Barrow); H.R. 5923: Patients Health Care Reform Act (Shadegg); H.R. 5955: Making Health Care More Affordable Act (Walberg); H.R. 5998: Protecting Children's Health Coverage Act (Pallone); H.R. 6071: Health Care Consumer Protection Act (provisions relating to reinstatement of health insurance following nonpayment of premiums) (Forbes); H.R. 6081: Heroes Earning Assistance and Relief Tax Act (mental health parity and FSA provisions); H.R. 6142: Lawsuits Against Employer-Sponsored Disability Benefit Plans (Andrews); H.R. 6210: Small Business Health Options Program Act (Kind-English); H.R. 6331: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) (Rangel-Dingell); H.R. 6388: GAO Improvement Act (provisions relating to access to Medicare part C/part D data) (Waxman); H.R. 6359: Medicare Beneficiary Protection Act (Biggert); H.R. 6365: Medicare Special Needs Plans Extension and Amendments Act (Kind); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 401: Keep Children Covered Act (Rockefeller); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 895: Children's Health First Act (Clinton); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1224: Children's Health Insurance Program Reauthorization Act (Rockefeller); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2819: Economic Recovery in Health Care Act (provisions relating to Medicaid funding) (Rockefeller); S. 2948: Small Business Empowerment Act (Brown); S. 2818: Small Business Health Plans Act (Enzi); S. 2999: Access to Cancer Clinical Trials Act (Brown); S. 3068: Equity in Prescription Insurance and Contraceptive Coverage Act (Snowe); S. 3101: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) (Baucus); S. 3115: Childrens Health Protection Act (Lautenberg); S. 3118: Preserving Access to Medicare Act (provisions relating to Medicare Advantage, Medicare Part D, Medicaid, and electronic prescribing)(Grassley). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including encounter data issues) bidding and payment issues (including MA coding intensity, Part D reinsurance, low income subsidies, application process, and audits), application process, and audits, benefit design rules, SSA and CMS premium withhold processing issues, systems issues affecting enrollment and disenrollment processing, enrollment rules, marketing materials review and approval, marketing activities, including conduct of brokers and agents and plan sponsor marketing staff and issues raised by CMS about Private Fee-for-Service (PFFS) plan marketing, measurement and oversight of plan performance including Special Needs Plans (SNPs); grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration issues for Special Needs Plans (SNPs); Federal premption of State authorization over MA and Part D plans, 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; physician quality reporting inititiative; issues relating to 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, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs) and federal matching funds for graduate medical education; coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; 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 health information technology standards and policies.

Client expense: $1,850,000 · 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 3001/ S 1340 - Shared and discusssed actuarial analysis of the CLASS Act regarding creation of a public insurance program for long-term services. S 2337/HR 3363 - Discussion of and support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070 Elder Justice Act/S 1577 Patient Safety and Abuse Prevention Act of 2007 - Support for both pieces of legislation and strategy for how they might both move forward this year. S 1340 Geriatric Assessment and Chronic Care Coordination Act of 2007- Discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill. S 2708 Caring for an Aging America Act of 2008 - Provisions related to increasing the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. HR 1174 Healthy Hospitals Act of 2007- Discussed with sponsors' staff potential endorsement of this legislation to require hospitals to report infection rates. HR 5613 Protecting the Medicaid Safety Net Act of 2008 - Supported this legislation, particularly provisions related to placing a moratorium on seven harmful Medicaid regulations. Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. Medicaid Personal Assistance Services State Plan option- discussion of comment letter sending and receipt. Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries. S 2480/HR 4296 Medicare Electronic Medication and Safety Protection (E-Meds) Act of 2007- Supported provisions related to requiring e-prescribing in Medicare Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641/ HR 5799 Nursing Home Quality and Transparency Legislation Act - To protect residents and support for the Nursing Home Transparency and Improvement Act. Discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill. Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality; poor performing nursing homes, family caregiving, nursing home compliance guidelines, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured - steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration. HR 5702 Advance Directive Promotion Act of 2008 - Negotiated provisions on portability of advance directives. HR 2642 - Lobbied for inclusion of Medicaid Regulation Moratoriam in Military Construction and Veterans Affairs Appropriations Act of 2008, and on supplemental appropriations bill. To build support for Medicaid Family Caregiver Assessment Demonstration proposal (no Bill). S 2838/HR 6126 - Input on draft legislation to make arbitration clauses between LTC facilities and their residents or representatives unenforceable; support for this legislation once it was introduced as the Fairness in Nursing Home Arbitration Act, including support letter. Discussion and input on legislation to improve the health/LTC workforce and support family caregivers. Advance directives and end-of-life care, education of the public about these issues, portability, and other issues relating to advance directives. S 1577/HR 3078 - Support for Patient Safety and Abuse Prevention Act (S 1577) and moving the issue forward; provided feedback and in testimony. S 2921 Caring for Wounded Warriors Act of 2008 - Services and supports for family caregivers of certain veterans. Feedback on draft legislation to provide chronic care coordination services to certain Medicare beneficiaries; approaches to improving chronic care for Medicare beneficiaries; discussion of chronic care and Special Needs Plans. S 1102 Part D Equity for Low-Income Seniors Act of 2007- Support for Medicare premium protection and modifications to Medicare Savings Programs/Part D Low-Income Subsidy. S 1758 - Long-term care financing proposals, including the CLASS Act, a public LTC financing program. S. 3164 - Lobbied on Medicare Fraud bill (Martinez and Cornyn) - All provisions related to protecting participants and the Medicare program from fraud and abuse. S. 3118 - Lobbied in opposition to Grassley-McConnell bill - All provisions related to beneficiary access and Medicare improvements, including e-prescribing. S 3101- Urged support of the Medicare Improvements for Patients and Providers Act of 2008 to help improve Medicare. Long Term Care/Reverse Mortgages - To protect consumers when reverse mortgages are used as a LTC financing tool. Green Houses and culture change in LTC facilities. HR 2642 - To keep moratorium on all seven Medicaid regulations in the supplemental appropriations bill. Lobbied on appeal notices for Medicare beneficiaries in Medicare Advantage plans. S 1102 - Lobbied for legislation to increase Medicare Part D LIS. HR 1536 - Lobbied for legislation to increase Medicare Part D LIS asset limits. S 3101/HR 6331 - (Medicare) Lobbied for legislation to protect part B premiums, increase LIS and MSP asset limits, and promote e-prescribing in Medicare. HR 2642 - (Medicaid) Lobbied for inclusion of Medicaid regulation moratorium in Iraq Supplemental.

Client expense: $6,480,000 · Firm income: Not reported

Government targets: Administration on Aging, Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 H.R.1459 To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S. 1107 Home and Community Services Copayment Equity Act of 2007 S 1102 Part D Equity for Low-Income Seniors Act of 2007 S. 2641 Nursing Home Transparency and Improvement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3162, Children's Health & Medicare Protection Act of 2007 (Medicare Payment/Reimbursement Reform); S.1218/HR 2034, Medicare for All Act (Medicare "buy-in"); S. 130/HR 1990, Medicare Cost Contract Extension & Retirement Act of 2007 (private sector role in Medicare); S 3/HR 4, Medicare Prescription Drug Price Negotiation Act of 2007 (Government Negotiation of Medicare Drug Prices); S 1102, Part D Equity for Low Income Seniors Act of 2007 (Special benefits for low income seniors); HR 1663, Medicare Mental Health Modernization Act of 2007 (Medicare Mental Health Parity); HR 976, Children's Health Insurance Program Reauthorization Act of 2007 (SHIP Extension and Expansion); HR 2184, Enhanced Health Care Value for All Act of 2007 (Comparative Effectiveness Research Institute; HR 971, Community Pharmacy Fairness Act of 2007 (Medicare Pharmacist Antitrust Exemption), HR 4327, Medicare Chronic Care Practice Network (Establish a Medicare Chronic Care Practice Research Network to develop and evaluate evidence based chronic care management for Medicare beneficiaries); HR 1193, Kidney Care Quality and Education Act of 2007 (Modernize and improve the Medicare ESRD program); HR 6331/S.3103, Medicare Improvements Act (dealing with physician reimbursements and Medicare Advantage funding cuts)

Client expense: $488,276 · Firm income: Not reported

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

Medicare/General. H.R. 205, H.R. 748, H.R. 1218, H.R. 1277, H.R. 1310, H.R. 1521, H.R. 2009, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025, H.R. 3061, H.R. 3162, H.R. 3932, H.R. 6331, S. 137, S. 250, S. 450, S. 706, S. 1887, S. 2089, S. 2115, S. 2219, S. 3101: provisions relating to enrollment periods and the late enrollment penalty, physician reimbursement rates, creating a Medicare-operated prescription drug plan, drug price negotiations, Medicare beneficiary improvements, repealing cost containment mandates, Medicare Advantage payments, Medicare Advantage stabilization fund, and comparative cost adjustment demonstration projects under the Medicare Modernization Act, therapy caps, liberalizing asset test limits, reducing the Part D benefit gap and guaranteeing prescription drug benefits. Medicare/Prescription Drug Price Negotiation. H.R. 4, H.R. 118, H.R. 5317, S. 3, S. 273: provisions pertaining to the negotiation of prescription drug prices under Medicare Part D. Medicare/Medicare Advantage. H.R. 2945: provision to provide beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. Medicare/Importation of Prescription Drugs. S. 242, H.R. 380, S.Amdt. 4299: provisions pertaining to the importation of prescription drugs. Medicare/Outpatient Psychiatric Services. H.R. 1571, H.R. 1663, H.R. 4897, S. 1715, S. 1854: provisions to eliminate discriminatory copayment rates for outpatient psychiatric services under Medicare Part B. Medicare/Geriatric Assessments. H.R. 2244, S. 1340: provisions to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. Medicare/Generic Drugs Market Exclusivity. H.R. 1432, H.R. 1902, S. 316, S. 1088: pertaining to market exclusivity for generic drugs. Medicare/Prescription Drug Benefits for Low Income Beneficiaries. H.R. 470, H.R. 932, H.R. 1536, H.R. 2058, H.R. 3127, S. 1102, S. 1103, S. 1107, S. 1108, S. 2101: provisions affecting prescription drug benefits for low-income beneficiaries under Medicare Parts B and D. Medicare/Part B Late Enrollment. H.R. 2591: provision limiting the penalty for late enrollment under Medicare Part B. Medicare/Marketing. H.R. 2307, H.R. 4790, S. 1883, S. 2687: provisions relating to the marketing of Medicare Advantage and Medicare Part D plans. Medicare/Health Care Vouchers. H.R. 749: provision to establish health care vouchers for seniors. Medicare/Medicare Savings Accounts. H.R. 2639, S. 173, S. 1019: provisions pertaining to Medicare Savings Accounts. Medicare/End-of-Life Planning. S. 464, S. 465, S. 466: pertaining to advance directives and end-of-life planning. Medicare/Means-testing. H.R. 4295, H.R. 4330, S. 2414, S.Amdt. 4240: pertaining to means-testing of Medicare Part D. Medicare/Presidents Funding Warning. H.R. 5480, S. 2662: proposals responding to the Presidents Medicare funding warning. Medicare/24-month Waiting Period. H.R.154, S. 2101: provisions phasing out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicaid/Federal Match. H.R. 5140: provisions pertaining to temporary increases in the federal Medicaid match. Medicaid/Targeted Case Management. Targeted Case Management: Interim final rule to implement Section 6052 of the Deficit Reduction Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.Con.Res. 99: Budget Resolution HR 1535: Children's Health First Act HR 2147: Healthy Kids Act HR 2851 Michelle's Law HR 2900: FDA Amendments Act HR 3341 Quality Health Care Coalition Act of 2007 HR 3425 Cancer Screening Coverage Act of 2007 HR 4460 Health Care Choice Act of 2007 HR 758 Breast Cancer Patient Protection Act of 2007 HR 836 Cyber-Security Enhancement and Consumer Data Protection Act of 2007 HR 948 Social Security Number Protection Act of 2007 HR 976 Childrens Health Insurance Program Reauthorization Act of 2007 S 1102: Part D Equity for Low-Income Seniors Act S 1224: Children's Health Insurance Program Reauthorization Act S 1408 Health Information Technology Act of 2007 S 1507: Access to Medicare Data Act S 1588 Children's Access to Reconstructive Evaluation and Surgery Act S 1893 Childrens Health Insurance Program Reauthorization Act of 2007 S 358 Genetic Nondiscrimination Act of 2007 S 40 National Insurance Act of 2007 S 400 Michelle's Law S 401: Keep Children Covered Act S 459 Breast Cancer Patient Protection Act of 2007 S 493 Genetic Information Nondiscrimination Act of 2007 S 495 Personal Data Privacy and Security of 2007 S 895: Children's Health First Act S ConRes. 21: Budget Resolution H.R.2761Terrorism Risk Insurance Extension Act Federal Terrorism Risk Insurance HR 2761 Terrorism Risk Insurance Act of 2007: All provisions related to housing and multifamily property insurance S. 558 Mental Health Parity Act H.R. 1424 Paul Wellstone Mental Health and Addiction Equity Act H.R. 493 Genetic Information Nondiscrimination Act H.R. 1424 Paul Wellstone Mental Health and Addiction Equity Act H.R. 3997 Tax Relief Act with MHP Extension S. 46 Affordability in the Individual Market Act S. 558 Mental Health Parity Act S. 2477 Health Care Choice Act H.R.920 To amend the National Flood Insurance Act of 1968 to provide for the national flood insurance program to make available multiperil coverage for damage resulting from windstorms or floods, and for other purposes. S.2449 : A bill to amend chapter 111 of title 28, United States Code, relating to protective orders, sealing of cases, disclosures of discovery information in civil actions, and for other purposes. S.1782 : A bill to amend chapter 1 of title 9 of United States Code with respect to arbitration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 H.R.1459 To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S. 1107 Home and Community Services Copayment Equity Act of 2007 S 1102 Part D Equity for Low-Income Seniors Act of 2007 S. 2641 Nursing Home Transparency and Improvement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel); H.R. 1535: Children's Health First Act (Dingell); H.R. 1663: Medicare Mental Health Modernization Act (Stark) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2147: Healthy Kids Act (Emanuel); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 401: Keep Children Covered Act (Rockefeller); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 895: Children's Health First Act (Clinton); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1224: Children's Health Insurance Program Reauthorization Act (Rockefeller); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. Con. Res. 70: Budget Resolution; (Conrad); H. Con. Res. 312: Budget Resolution, section 201 (Spratt). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, bidding and payment issues (including MA coding intensity, 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, marketing activities, including conduct of brokers and agents and plan sponsor marketing staff and issues raised by CMS about Private Fee-for-Service (PFFS) plan marketing, measurement and oversight of plan performance including Special Needs Plans (SNPs), grievance and appeals processes, Medicare/Medicaid integration issues for Special Needs Plans (SNPs), 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; physician quality reporting inititiative; issues relating to 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, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs) and federal matching funds for graduate medical education; coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; 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 health information technology standards and policies.

Client expense: $1,820,000 · 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

H.Con.Res. 99: Budget Resolution HR 1535: Children's Health First Act HR 2147: Healthy Kids Act HR 2761 Terrorism Risk Insurance Revision and Extension Act of 2007 HR 2851 Michelle's Law HR 2900: FDA Amendments Act HR 3341 Quality Health Care Coalition Act of 2007 HR 3425 Cancer Screening Coverage Act of 2007 HR 4460 Health Care Choice Act of 2007 HR 758 Breast Cancer Patient Protection Act of 2007 HR 836 Cyber-Security Enhancement and Consumer Data Protection Act of 2007 HR 948 Social Security Number Protection Act of 2007 HR 976 Childrens Health Insurance Program Reauthorization Act of 2007 S 1102: Part D Equity for Low-Income Seniors Act S 1224: Children's Health Insurance Program Reauthorization Act S 1408 Health Information Technology Act of 2007 S 1507: Access to Medicare Data Act S 1588 Children's Access to Reconstructive Evaluation and Surgery Act S 1893 Childrens Health Insurance Program Reauthorization Act of 2007 S 358 Genetic Nondiscrimination Act of 2007 S 40 National Insurance Act of 2007 S 400 Michelle's Law S 401: Keep Children Covered Act S 459 Breast Cancer Patient Protection Act of 2007 S 493 Genetic Information Nondiscrimination Act of 2007 S 495 Personal Data Privacy and Security of 2007 S 895: Children's Health First Act S ConRes. 21: Budget Resolution

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage - HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; HConRes 312, CONCURRENT RESOLUTION ON THE BUDGET FOR FISCAL YEAR 2009; SConRes 70, Setting forth the congressional budget for the United States Government for fiscal year 2009. Medicare issues - S 706, Medicare Advantage Stabilization Fund; S 130, Medicare Cost Contract Extension/Refinement; HR 1990, Medicare Cost Contract Extension/Refinement; HR 4, Medicare Prescription Drug Price Negotiation; S 3, Medicare Prescription Drug Price Negotiation; S 1102, Medicare Part D Equity for Low Income Seniors; S 1103, Helping Fill the Medicare RX Gap; S 1107, Home-Community Services Copayment Equity; S 1108, Medicare Part D Outreach /Enrollment; HR 1663, Medicare Mental Health Modernization; HR 1535, Children's Health First Act; S 895, Children's Health First Act; S 1224, Children's Health Insurance Program Reauthorization; HR 2147, Healthy Kids Act; HR 2945, Medicare Advantage Truth in Advertising; S 799, Community Choice Act; S 401, Keep Children Covered Act; S 1544, Medicare Quality Enhancement Act; S 1507, Access to Medicare Data; S 1827, Pharmacist Access/Recognition in Medicare; HR 3025, Medicare Prescription Drug Savings for Seniors; HR 3061, Medicare Part D Drug Class Protection; HR 3162, Children's Health and Medicare Protection; HR 976, Children's Health Insurance Program Reauthorization; S 1893, Children's Health Insurance Program Reauthorization; S 1954, Pharmacy Access Improvement; S 2219, Medicare Prescription Drug Savings and Choice; HR 3932, Medicare Prescription Drug Savings and Choice; S 2408, Medicare Electronic Medication and Safety Protection; HR 4296, Medicare Electronic Medication and Safety Protection; S 1200, Indian Health Care Improvement Act; HR 5480, Medicare Funding Warning Response Act; S 2662, Medicare Funding Warning Response Act; HR 5268, Medicaid FMAP; S 2620, Medicaid FMAP

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

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

HR 3162, Children's Health & Medicare Protection Act of 2007 (Medicare Payment/Reimbursement Reform); S.1218/HR 2034, Medicare for All Act (Medicare "buy-in"); S. 130/HR 1990, Medicare Cost Contract Extension & Retirement Act of 2007 (private sector role in Medicare); S 3/HR 4, Medicare Prescription Drug Price Negotiation Act of 2007 (Government Negotiation of Medicare Drug Prices); S 1102, Part D Equity for Low Income Seniors Act of 2007 (Special benefits for low income seniors); HR 1663, Medicare Mental Health Modernization Act of 2007 (Medicare Mental Health Parity); HR 976, Children's Health Insurance Program Reauthorization Act of 2007 (SHIP Extension and Expansion); HR 2184, Enhanced Health Care Value for All Act of 2007 (Comparative Effectiveness Research Institute; HR 971, Community Pharmacy Fairness Act of 2007 (Medicare Pharmacist Antitrust Exemption), HR 4327, Medicare Chronic Care Practice Network (Establish a Medicare Chronic Care Practice Research Network to develop and evaluate evidence based chronic care management for Medicare beneficiaries); HR 1193, Kidney Care Quality and Education Act of 2007 (Modernize and improve the Medicare ESRD program)

Client expense: $575,459 · Firm income: Not reported

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

Medicare/General. H.R. 205, H.R. 748, H.R. 1218, H.R. 1277, H.R. 1310, H.R. 1521, H.R. 2009, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025, H.R. 3061, H.R. 3162, H.R. 3932, S. 137, S. 250, S. 450, S. 706, S. 1887, S. 2089, S. 2115, S. 2219: provisions relating to enrollment periods and the late enrollment penalty, physician reimbursement rates, creating a Medicare-operated prescription drug plan, drug price negotiations, Medicare beneficiary improvements, repealing cost containment mandates, Medicare Advantage payments, Medicare Advantage stabilization fund, and comparative cost adjustment demonstration projects under the Medicare Modernization Act, therapy caps, liberalizing asset test limits, Medicare Secondary Payer clarification, reducing the Part D benefit gap and guaranteeing prescription drug benefits. Medicare/Prescription Drug Price Negotiation. H.R. 4, H.R. 118, H.R. 5317, S. 3, S. 273: provisions pertaining to the negotiation of prescription drug prices under Medicare Part D. Medicare/Medicare Advantage. H.R. 2945: provision to provide beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. Medicare/Importation of Prescription Drugs. S. 242, H.R. 380, S.Amdt. 4299: provisions pertaining to the importation of prescription drugs. Medicare/Outpatient Psychiatric Services. H.R. 1571, H.R. 1663, H.R. 4897, S. 1715, S. 1854: provisions to eliminate discriminatory copayment rates for outpatient psychiatric services under Medicare Part B. Medicare/Geriatric Assessments. H.R. 2244, S. 1340: provisions to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. Medicare/Generic Drugs Market Exclusivity. H.R. 1432, H.R. 1902, S. 316, S. 1088: pertaining to market exclusivity for generic drugs. Medicare/Prescription Drug Benefits for Low Income Beneficiaries. H.R. 470, H.R. 932, H.R. 1536, H.R. 2058, H.R. 3127, S. 1102, S. 1103, S. 1107, S. 1108, S. 2101: provisions affecting prescription drug benefits for low-income beneficiaries under Medicare Parts B and D. Medicare/Part B Late Enrollment. H.R. 2591: provision limiting the penalty for late enrollment under Medicare Part B. Medicare/Marketing. H.R. 2307, H.R. 4790, S. 1883, S. 2687: provisions relating to the marketing of Medicare Advantage and Medicare Part D plans. Medicare/Health Care Vouchers. H.R. 749: provision to establish health care vouchers for seniors. Medicare/Medicare Savings Accounts. H.R. 2639, S. 173, S. 1019: provisions pertaining to Medicare Savings Accounts. Medicare/End-of-Life Planning. S. 464, S. 465, S. 466: pertaining to advance directives and end-of-life planning. Medicare/Means-testing. H.R. 4295, H.R. 4330, S. 2414, S.Amdt. 4240: pertaining to means-testing of Medicare Part D. Medicare/Presidents Funding Warning. H.R. 5480, S. 2662: proposals responding to the Presidents Medicare funding warning. Medicare/24-month Waiting Period. H.R.154, S. 2101: provisions phasing out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicaid/Federal Match. H.R. 5140: provisions pertaining to temporary increases in the federal Medicaid match. Medicaid/Targeted Case Management. Targeted Case Management: interim final rule to implement Section 6052 of the Deficit Reduction Act.

Client expense: $480,000 · Firm income: Not reported

Medicare. 1) H.R. 4, H.R. 118, S. 3, S. 273: provisions pertaining to the negotiation of prescription drug prices under Medicare Part D. 2) H.R. 205, H.R. 748, H.R. 1218, H.R. 1277, H.R. 1310, H.R. 1521, H.R. 2009, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025, H.R. 3061, H.R. 3162, H.R. 3932, S. 137, S. 250, S.450, S. 706, S. 1887, S. 2115, S. 2219, S. 2499, S.Amdt. 508: provisions relating to the late enrollment penalty, physician reimbursement rates, creation of a Medicare operated prescription drug plan, drug price negotiations, Medicare beneficiary improvements, repeal of cost containment provisions, Medicare Advantage payments, the Medicare Advantage stabilization fund and comparative cost adjustment demonstration projects under the Medicare Modernization Act, therapy caps, liberalization of asset test limits, the reduction of the benefit gap and guaranteeing drug benefits. 3) H.R. 2945: provisions to provide beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. 4) S. 242, H.R. 380, S.Amdt. 1010: pertaining to the importation of prescription drugs. 5) H.R. 1571, H.R. 1663, H.R. 4897, S. 1715, S. 1854: provisions to eliminate discriminatory copayment rates for outpatient psychiatric services under the Medicare Program. 6) S. 1340, H.R. 2244: provisions to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. 7) S. 316, S. 1088, H.R. 1432, H.R. 1902: pertaining to market exclusivity for generic drugs. 8) S. 1102, S. 1103, S. 1107, S. 1108, S. 2101, H.R. 470, H.R. 932, H.R. 1536, H.R. 2058, H.R. 3127, H.R. 3668: provisions to improve benefits for low-income beneficiaries under Medicare Parts B and D. 9) S. 1082: amendments pertaining to citizen petitions to the Federal Drug Administration relating to generic drugs and to importation of prescription drugs under the Medicare program. 10) H.R. 2591: limiting the penalty for late enrollment under Medicare Part B. 11) H.R. 2307, H.R. 4790, S. 1883: provisions regarding the marketing of Medicare Advantage and Medicare Part D plans. 12) H.R. 749: establishing health care vouchers for seniors. 13) S. 173, S. 1019, H.R. 2639: provisions pertaining to Medicare Savings Accounts. 14) S. 464, S. 465, S. 466: provisions pertaining to advance directives and end-of-life planning. 15) S.Amdt. 472: provisions pertaining to means-testing of Medicare Part D. 16) S.Amdt. 525: pertaining to across-the-board cuts to Medicare providers. 17) S. 543, H.R. 1459: rules pertaining to Inpatient Rehabilitation Facilities. 18) Pertaining to Congressional efforts petitioning the Center for Medicare and Medicaid Services to create a public nursing home watch list of repeat offenders on surveys (no legislation).

Client expense: $4,440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare. 1) H.R. 4, H.R. 118, S. 3, S. 273: pertaining to the negotiation of prescription drug prices under Medicare Part D. 2) H.R. 205, H.R. 1218, H.R. 1310, H.R. 1521, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025, H.R. 3061, S. 250, S. 706: provisions relating to the late enrollment penalty, creating a Medicare operated prescription drug plan, prescription drug price negotiations, repealing cost containment provisions, Medicare Advantage stabilization fund and comparative cost adjustment demonstration projects under the Medicare Modernization Act (P.L. 108-173), liberalizing asset test limits, reducing the benefit gap and guaranteeing prescription drug benefits. 3) H.R. 2945: providing beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. 4) S. 242, H.R. 380: pertaining to the importation of prescription drugs. 5) H.R. 1571, H.R. 1663, S. 1715: eliminating discriminatory copayment rates for outpatient psychiatric services under the Medicare Program. 6) S. 1340, H.R. 2244: to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. 7) S. 316, S. 1088, H.R. 1432, H.R. 1902: pertaining to market exclusivity for generic drugs. 8) S. 1102, S. 1103, S. 1107, S. 1108, H.R. 470, H.R. 932, H.R. 1536, H.R. 2058: improving prescription drug benefits for low-income beneficiaries under Medicare Part D. 9) S. 1082: amendments pertaining to citizen petitions to the Federal Drug Administration relating to generic drugs and to importation of prescription drugs under the Medicare program. 10) H.R. 2591: limiting the penalty for late enrollment under Medicare Part B. 11) H.R. 2009: repealing the Medicare cost containment provisions of the Medicare Modernization Act (P.L. 108-173). 12) H.R. 2307: protecting seniors from abusive marketing scams in Medicare Advantage. 13) H.R. 749: establishing health care vouchers for seniors. 14) S. 173, S. 1019, H.R. 2639: pertaining to Medicare Savings Accounts. 15) S. 464, S. 465, S. 466: pertaining to advance directives and end-of-life planning.

Client expense: $4,860,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached list S. 250, Medicare Enhancements for Needed Drugs Act of 2007 S.581.IS, Medicare Prescription Drug Cost Containment Act S.273, Prescription Drug and Health Improvement Act of 2007 S.2665, Medicare Prescription Drug Simplification Act S.2563, Pharmacist Access and Recognition in Medicare (PhARM) S.2255-7, Medicare Drug Formulary Protection Act S.173, Medicare Health Savings Accounts Act of 2007 S.1544, Medicare Quality Enhancement Act of 2007 S.137, Preserving Medicare for All Act of 2007 S.1340, Geriatric Assessment and Chronic Care Coordination Act of 2007 S.130, Medicare Cost Contract Extension and Refinement Act of 2007 S.1218, Medicare for All Act S.1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007 S.1103, Helping Fill the Medicare Rx Gap Act of 2007 S.1102, Part D Equity for low Income Seniors Act of 2007 S.1052, Healthy Children and Families Act of 2007 S.028, Generics First Act of 2007 S.003, Medicare Prescription Drug Price Negotiation Act of 2007 S.885, Community Pharmacy Fairness Act of 2007 S.273, Prescription Drug Health Improvement Act of 2007 S.2601/H.R.4551, Health Care Choices for Seniors Act H.R.4, Medicare Prescription Drug Price Negotiation Act of 2007 H.R.971, Community Pharmacy Fairness Act of 2007 H.R.749, Health Care Choices for Senior Act H.R.3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R.2945, Medicare Advantage Truth in Advertising Act of 2007 H.R.2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R.2685.IH, Medicare Prescription Drug Price Negotiation Act H.R.2307, Preventing Medicare Seniors from being Confused due to Abusive Marketing (Prevent Medicare SCAMs) Act of 2007 H.R.2159/S.630, Rural Health Services Preservation Act of 2007 H.R.2149, Healthcare Eligibility for Late Participants (HELP) in Medicare Part D Act of 2007 H.R.2065, Medicare Drug Savings Through Choice Act of 2007 H.R.2058, Helping fill the Medicare Rx Gap Act of 2007 H.R.2056, Medicare Part D Improvement Act of 2007 H.R.2055, Improving Childrens Access to Health Care Act of 2007 H.R.205, Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.2034, Medicare for All Act H.R.1990, Medicare Cost Contract Extension and Refinement Act of 2007 H.R.195, Seniors Health Care Freedom Act of 2007 H.R.1536, Prescription Coverage Now Act of 2007 H.R.1521, Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D H.R.1310, Relief and Elimination of the Medicare Enrollment Deadline Penalty (REMEDY) Act or 2007 H.R.1277, Medicare Prescription Drug Benefit Gap Elimination Act of 2007 H.R.1218, Medicare Prescription Drug Improvement Act H.R.118, To amend part D of Title XVIII of the Social Security Act to authorize the secretary of HHS to negotiate prices for part D covered drugs for Medicare beneficiaries H.R.1046, Medicare Quality Improvement Organization Modernization Act of 2007 H.R.004, Medicare Prescription Drug Price Negotiation Act of 2007

Client expense: $460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Transportation, Dept of (DOT), UNDETERMINED, White House Office

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 1535: Children's Health First Act (Dingell); H.R. 1663: Medicare Mental Health Modernization Act (Stark) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2147: Healthy Kids Act (Emanuel); H.R. 2206: Supplemental Appropriations Act (Obey); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.Con.Res. 99: Budget Resolution (Spratt); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 401: Keep Children Covered Act (Rockefeller); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 895: Children's Health First Act (Clinton); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1224: Children's Health Insurance Program Reauthorization Act (Rockefeller); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1701: TMA/Medicare Advantage (Baucus); S.Con.Res. 21: Budget Resolution (Conrad) 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, marketing activities, including conduct of brokers and agents and plan sponsor marketing staff and issues raised by CMS about Private Fee-for-Service (PFFS) plan marketing, measurement and oversight of plan performance, grievance and appeals processes, Medicare/Medicaid integration issues for Special Needs Plans (SNPs), 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, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs) and federal matching funds for graduate medical education; coordination of benefits with state Medicaid programs; 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; 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.

Client expense: $3,420,000 · 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), Federal Trade Commission (FTC), 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, UNDETERMINED

HR 4-Drug Price Negotiation; HR 976-Children's Health Ins. Reauthorization Act; HR 1535-Children's Health First Act; HR 2147-Healthy Kids Act; HR 2945-Medicare Advantage Truth in Advertising Act; HR 3162- Children's Health and Medicare Protection Act; HR 3693-Children's Health Ins. Program Reauthorization Act; S. 3-Drug Price Negotiation; S. 401-Keep Children Covered Act; S. 1102-Part D Equity for Low-Income Seniors Act; S. 1103-Helping Fill the Medicare Rx Gap Act;

Client expense: $2,240,000 · Firm income: Not reported

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

H.R. 1535 Children's Health First Act H.R. 2147 Healthy Kids Act S. 401 Keep Children Covered Act S. 1102 Part D Equity for Low-Income Seniors Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3061, H.R. 3162, H.R. 3932, S. 137, S. 250, S.450, S. 706, S. 1887, S. 2115, S. 2219, S. 2499, S.Amdt. 508: provisions relating to the late enrollment penalty, physician reimbursement rates, creation of a Medicare operated prescription drug plan, drug price negotiations, Medicare beneficiary improvements, repeal of cost containment provisions, Medicare Advantage payments, the Medicare Advantage stabilization fund and comparative cost adjustment demonstration projects under the Medicare Modernization Act, therapy caps, liberalization of asset test limits, the reduction of the benefit gap and guaranteeing drug benefits. 3) H.R. 2945: provisions to provide beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. 4) S. 242, H.R. 380, S.Amdt. 1010: pertaining to the importation of prescription drugs. 5) H.R. 1571, H.R. 1663, H.R. 4897, S. 1715, S. 1854: provisions to eliminate discriminatory copayment rates for outpatient psychiatric services under the Medicare Program. 6) S. 1340, H.R. 2244: provisions to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. 7) S. 316, S. 1088, H.R. 1432, H.R. 1902: pertaining to market exclusivity for generic drugs. 8) S. 1102, S. 1103, S. 1107, S. 1108, S. 2101, H.R. 470, H.R. 932, H.R. 1536, H.R. 2058, H.R. 3127, H.R. 3668: provisions to improve benefits for low-income beneficiaries under Medicare Parts B and D. 9) S. 1082: amendments pertaining to citizen petitions to the Federal Drug Administration relating to generic drugs and to importation of prescription drugs under the Medicare program. 10) H.R. 2591: limiting the penalty for late enrollment under Medicare Part B. 11) H.R. 2307, H.R. 4790, S. 1883: provisions regarding the marketing of Medicare Advantage and Medicare Part D plans. 12) H.R. 749: establishing health care vouchers for seniors. 13) S. 173, S. 1019, H.R. 2639: provisions pertaining to Medicare Savings Accounts. 14) S. 464, S. 465, S. 466: provisions pertaining to advance directives and end-of-life planning. 15) S.Amdt. 472: provisions pertaining to means-testing of Medicare Part D. 16) S.Amdt. 525: pertaining to across-the-board cuts to Medicare providers. 17) S. 543, H.R. 1459: rules pertaining to Inpatient Rehabilitation Facilities. 18) Pertaining to Congressional efforts petitioning the Center for Medicare and Medicaid Services to create a public nursing home “watch list” of repeat offenders on surveys (no legislation). Medicare. 1) H.R. 4, H.R. 118, S. 3, S. 273: provisions pertaining to the negotiation of prescription drug prices under Medicare Part D. 2) H.R. 205, H.R. 748, H.R. 1218, H.R. 1277, H.R. 1310, H.R. 1521, H.R. 2009, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025,

Client expense: $4,440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA)

Medicare Payment and operational issues. HR 3162, Children's Health Insurance Progam Reauthorization Act of 2007, HR 1591, S.6706, S.130, HR 1990, HR 4, S.3, S.1102, HR 1663, HR 594, HR 976, HR 1843, HR 2184, S.2499

Client expense: $872,033 · Firm income: Not reported

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

S. 706: Medicare Advantage Stabilization Fund H.R. 4: Medicare Prescription Drug Price Negotiation Act S. 3: Medicare Prescription Drug Price Negotiation Act S. 1102: Part D Equity for Low-Income Seniors Act S. 1103: Helping Fill the Medicare Rx Gap Act S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act H.R. 1663: Medicare Mental Health Modernization Act S.Con.Res. 21: Budget Resolution H.Con.Res. 99: Budget Resolution H.R. 1535: Children's Health First Act S. 895: Children's Health First Act S. 1224: Children's Health Insurance Program Reauthorization Act H.R. 2147: Healthy Kids Act S. 1701: TMA/Medicare Advantage S. 401: Keep Children Covered Act S. 1544: Medicare Quality Enhancement Act S. 1507: Access to Medicare Data Act H.R. 2058 Helping Fill the Medicare Rx Gap Act of 2007 S. 1218 Medicare for All Act H.R. 2034 Medicare for All Act H.R. 2065 Medicare Drug Savings through Choice Act of 2007 S. 137 Preserving Medicare for All Act of 2007 H.R. 205 Medicare Prescription Drug Enrollment Extension Act of 2007 H.R. 1521 Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D H.R. 118 To amend part D title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate prices for part D covered drugs for Medicare beneficiaries H.R. 2056 Medicare Part D Improvement Act of 2007 S. 1507 Access to Medicare Data Act of 2007 H.R. 1536 Prescription Coverage Now Act of 2007 S. 28 Generics First Act of 2007 H.R. 932 To amend part D of title XVIII of the Social Security Act to limit the monthly amount of prescription drug cost-sharing for full-benefit dual eligible individuals H.R. 2945 Medicare Advantage Truth in Advertising Act of 2007 S. 273 Prescription Drug and Health Improvement Act of 2007 S. 1108 Medicare Part D Outreach and Enrollment Enhancement Act of 2007 HR 205 Medicare Prescription Drug Enrollment Extension Act of 2007 HR 1218 Medicare Prescription Drug Improvement Act HR 1521 Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D HR 2009 To repeal the Medicare cost containment provisions contained in subtitle A of title VIII of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. HR 2043 Medicare for All Act HR 2058 Helping Fill the Medicare Rx Gap Act of 2007 HR 2065 Medicare Drug Savings Through Choice Act of 2007 HR 2149 Healthcare Eligibility for Late Participants (HELP) in Medicare Part D Act of 2007 HR 2307 Preventing Medicare Seniors from being Confused due to Abusive Marketing (Prevent Medicare SCAMs) Act of 2007 HR 2827 Medicare Equity and Accessibility Act of 2007 S 130 Medicare Cost Contract Extension and Refinement Act of 2007 S 137 Preserving Medicare for All Act of 2007 S 173 Medicare Health Savings Accounts Act of 2007 S 1338 Access to Medicare Imaging Act of 2007

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4-Drug Price Negotiation; HConRes 99-Budget Resolution; HR 1535-Children's Health First Act; HR 2147-Healthy Kids Act; S 3-Drug Price Negotiation; SConRes 21-Budget Resolution; S 401-Keep Children Covered Act; S 1102-Part D Equity for Low-Income Seniors Act; S 1103-Helping Fill the Medicare Rx Gap Act; S 1224-Children's Health Insurance Program Reauthorization Act; S 1507-Access to Medicare Data Act; S 1544-Medicare Quality Enhancement Act; S 1701-TMA/Medicare Advantage

Client expense: $2,320,000 · Firm income: Not reported

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

S. 895, H.R. 1535, Children's Health First Act S. 1052, H.R. 3024, Healthy Children and Families Act of 2007 S.1364, H.R. 2147, Healthy Kids Act of 2007 S. 1893, H.R. 3162 and H. Res. 594, Children's Health Insurance Program Reauthorization Act of 2007 and Children's Health and Medicare Protection Act of 2007 S. 1102, Part D Equity for Low-Income Seniors Act of 2007 S. 1103, Helping Fill the Medicare Rx Gap Act of 2007 S. 1107, Home and Community Services Copayment Equity Act of 2007 S. 1108, Part D Outreach and Enrollment Enhancement Act of 2007 S. 1224, Children's Health Insurance Program (CHIP) Reauthorization Act of 2007 S. 1337, Children's Mental Health Parity Act H.R. 976, Small Business Tax Relief Act of 2007 - CHIP Reauthorization in Senate H.R. 2945, Medicare Advantage Truth in Advertising Act of 2007 Supported all provisions unless otherwise specified S. 3, H.R. 4, Medicare Prescription Drug Price Negotiation Act of 2007 S. 95, H.R. 1111, Kids Come First Act of 2007 S. 764, H.R. 1308, Legal Immigrant Children's Health Improvement Act of 2007

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.4, Medicare Prescription Drug Price Negotiation Act of 2007 H.R.971, Community Pharmacy Fairness Act of 2007 H.R.749, Health Care Choices for Senior Act H.R.3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R.2945, Medicare Advantage Truth in Advertising Act of 2007 H.R.2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R.2685.IH, Medicare Prescription Drug Price Negotiation Act H.R.2307, Preventing Medicare Seniors from being Confused due to Abusive Marketing (Prevent Medicare SCAMs) Act of 2007 H.R.2159/S.630, Rural Health Services Preservation Act of 2007 H.R.2149, Healthcare Eligibility for Late Participants (HELP) in Medicare Part D Act of 2007 H.R.2065, Medicare Drug Savings Through Choice Act of 2007 H.R.2058, Helping fill the Medicare Rx Gap Act of 2007 H.R.2056, Medicare Part D Improvement Act of 2007 H.R.2055, Improving Children’s Access to Health Care Act of 2007 H.R.205, Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.2034, Medicare for All Act H.R.1990, Medicare Cost Contract Extension and Refinement Act of 2007 H.R.195, Seniors’ Health Care Freedom Act of 2007 H.R.1536, Prescription Coverage Now Act of 2007 H.R.1521, Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D H.R.1310, Relief and Elimination of the Medicare Enrollment Deadline Penalty (REMEDY) Act or 2007 H.R.1277, Medicare Prescription Drug Benefit Gap Elimination Act of 2007 H.R.1218, Medicare Prescription Drug Improvement Act H.R.118, To amend part D of Title XVIII of the Social Security Act to authorize the secretary of HHS to negotiate prices for part D covered drugs for Medicare beneficiaries H.R.1046, Medicare Quality Improvement Organization Modernization Act of 2007 H.R.004, Medicare Prescription Drug Price Negotiation Act of 2007 S. 250, Medicare Enhancements for Needed Drugs Act of 2007 S.581.IS, Medicare Prescription Drug Cost Containment Act S.273, Prescription Drug and Health Improvement Act of 2007 S.2665, Medicare Prescription Drug Simplification Act S.2563, Pharmacist Access and Recognition in Medicare (PhARM) S.2255-7, Medicare Drug Formulary Protection Act S.173, Medicare Health Savings Accounts Act of 2007 S.1544, Medicare Quality Enhancement Act of 2007 S.137, Preserving Medicare for All Act of 2007 S.1340, Geriatric Assessment and Chronic Care Coordination Act of 2007 S.130, Medicare Cost Contract Extension and Refinement Act of 2007 S.1218, Medicare for All Act S.1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007 S.1103, Helping Fill the Medicare Rx Gap Act of 2007 S.1102, Part D Equity for low Income Seniors Act of 2007 S.1052, Healthy Children and Families Act of 2007 S.028, Generics First Act of 2007 S.003, Medicare Prescription Drug Price Negotiation Act of 2007 S.885, Community Pharmacy Fairness Act of 2007 S.273, Prescription Drug Health Improvement Act of 2007 S.2601/H.R.4551, Health Care Choices for Seniors Act See attached list.

Client expense: $460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Transportation, Dept of (DOT), White House Office

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, marketing activities, including conduct of brokers and agents and plan sponsor marketing staff and issues raised by CMS about Private Fee-for-Service (PFFS) plan marketing, measurement and oversight of plan performance, grievance and appeals processes, Medicare/Medicaid integration issues for Special Needs Plans (SNPs), 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, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs) and federal matching funds for graduate medical education; coordination of benefits with state Medicaid programs; 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; 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. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2147: Healthy Kids Act (Emanuel); H.R. 2206: Supplemental Appropriations Act (Obey); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.Con.Res. 99: Budget Resolution (Spratt); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 401: Keep Children Covered Act (Rockefeller); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 895: Children's Health First Act (Clinton); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1224: Children's Health Insurance Program Reauthorization Act (Rockefeller); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1701: TMA/Medicare Advantage (Baucus); S.Con.Res. 21: Budget Resolution (Conrad) MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 1535: Children's Health First Act (Dingell); H.R. 1663: Medicare Mental Health Modernization Act (Stark) (continued)

Client expense: $3,420,000 · 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), Federal Trade Commission (FTC), 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

S. 1107 Home and Community Services Copayment Equity Act of 2007 S. 1102 Part D Equity for Low-Income Seniors Act of 2007 S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007. H.R. 1459 To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Payment and operational issues. HR 3162, Children's Health Insurance Program Reauthorization Act of 2007, HR 1591, S. 706, S. 130, HR 1990, HR 4, S. 3, S. 1102, HR 1663, HR 594, HR 976, HR 1843

Client expense: $1,219,469 · Firm income: Not reported

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

H.R. 1688 All Healthy Children Act of 2007 S. 325 Health Partnership Act H.R. 15 National Health Insurance Act S. 1169 State Based Health Reform Act S. 1564 All Healthy Children Act of 2007 H.R. 1329 Guaranteed Access for SCHIP’s Target Population Act of 2007 S. 1221 Countdown to Coverage Act of 2007 H.R. 2639 Promoting Health for Future Generations Act of 2007 S. 273 Prescription Drug and Health Improvement Act of 2007 H.R. 2971 Health Care Accountability Act S. 1102 Part D Equity for Low Income Seniors Act of 2007 S. 1753 Health Workforce Act of 2007 S. 1455 National Health Information Technology and Privacy Advancement Act of 2007 S. 1218 Medicare for All Act H.R. 2034 Medicare for All Act S. 895 Children’s Health First Act H.R. 2995 Small Business Liability Reform Act of 2007 H.R. 1012 Small Business Growth Act of 2007 H.R. 1542 Healthy Families Act H.R. 1626 Family Health Care Accessibility Act of 2007 S. 733 Promoting Health Care Purchasing Cooperatives Act H.R. 2351 HealthCARE Act 2007 S. 40 National Insurance Act of 2007 H.R. 493 Genetic Information Nondiscrimination Act of 2007 S. 359 Genetic Information Nondiscrimination Act of 2007 H.R. 677 The Nursing School Capacity Act of 2007 S. 446 Nurse Education, Expansion, and Development Act 0f 2007 H.R. 772 Nurse Education, Expansion, and Development Act 0f 2007 S. 605 Allied Health Reinvestment Act S. 620 Community – Based Health Care Retraining Act H.R. 1279 Direct Support Professionals Fairness and Security Act of 2007 H.R. 1134 Physical Therapist Student Loan Repayment Eligibility Act of 2007 S. 718 Patient – Focused Critical Care Enhancement Act H.R. 1884 National Health Service Corps Improvement Act of 2007 Act H.R. 410 United States Physician Shortage Elimination Act S.224 Standards to Provide Educational Achievement for All Kids H.R. 325 Standards to Provide Educational Achievement for All Kids H.R. 2497 Fair and Reliable Medical Justice Act S. 1481 Fair and Reliable Medical Justice Act H.R. 1174 Healthy Hospitals Act of 2007 H.R. 378 Nurse and Patient Safety and Protection Act of 2007 H.R. 2123 Nurse Staff and Standards for Patient Safety and Quality Care Act of 2007 S. 628 Critical Access to Health Information Technology Act of 2007 S. 1408 Health Information Technology Act of 2007 S. 1577 Patient Safety and Abuse Prevention Act of 2007 S. 1693 Wired for Health Care Quality Act H.R. 2723 Children’s Healthcare Quality Act S. 1226 Children’s Healthcare Quality Act H.R. 1952 National Health Information Incentive Act of 2007 H. R. 2580 Help Efficient, Accessible, Low cost, Timely Healthcare (HEALTH) Act of 2007 S. 1364 Healthy Kids Act of 2007 S. 484 Enhancing Drug Safety and Innovation Act of 2007 H.R. 1561 Enhancing Drug Safety and Innovation Act of 2007 S. 1082 Prescription Drug User Fee Amendments of 2007 H.R. 3014 Health Equity and Accountability Act of 2007 H.R. 1165 SAFE Drug Act S. 1023 “To amend Title XXI of the Social Security Act […]” S. 554 Act for our Kids H.R. 1200 American Health Security Act of 2007 H.R. 15 National Health Insurance Act S. 1224 Children’s Health Insurance Program (CHIP) Reauthorization Act of 2007 H.R. 1368 Personalized Health Information Act of 2007 H.R. 676 United States National Health Insurance Act H.R. 1459 “To improve Medicare beneficiary access […]” H.R. 2737 Health Care Relief Act of 2007 S. 1714 Small Business Children’s Health Education Act of 2007 S. 1198 HealthCARE Act of 2007 H.R. 1802 Keeping Small Business Healthy Act of 2007 H.R. 2626 Comprehensive HealthCARE Act of 2007 H.R. 2842 Children’s Health Protection Act of 2007 S. 95 Kids Come First Act of 2007 H.R. 1111 Kids Come First Act of 2007 H.R. 493 Genetic Information Non-Discrimination Act of 2007 H.R. 2948 Increased Access to Health Insurance Act of 2007 S. 158 Access to Affordable Health Care Act S. 358 Genetic Information Non-Discrimination Act of 2007 H.R. 1012 Small Business Growth Act of 2007 H.R. 2147 Health Kids Act of 2007 S. 1298 Healthy Businesses, Healthy Workers Reinsurance Act of 2007 S. 21 Prevention First Act H.R. 819 Prevention First Act H.R. 593 Children’s Health Insurance Promotion Act of 2007 H.R. 1666 Health Care Price Transparency Promotion Act of 2007 H.R. 2302 Health Insurance Affordability Act of 2007 H.R. 2359 SBA Entrepreneurial Development Programs Act of 2007 H.R. 2357 MediKids Health Insurance Act of 2007 S. 401 Keep Children Covered Act of 2007 S. 2512 Reducing Coverage Gaps for Kids Act of 2007 H.R. 2055 Improving Children’s Access to Health Care Act of 2007 S. 1213 Children’s Express Lane to Heath Coverage Act of 2007 S. 334 Healthy Americans Act S. 1019 Universal Healthcare Choice and Access Act H.R. 1535 Children's Health First Act S. 895 Children's Health First Act

Client expense: $460,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2034 Medicare for All Act H.R. 2065 Medicare Drug Savings through Choice Act of 2007 S. 137 Preserving Medicare for All Act of 2007 H.R. 205 Medicare Prescription Drug Enrollment Extension Act of 2007 S. 3 Medicare Prescription Drug Price Negotiation Act of 2007 H.R. 4 Medicare Prescription Drug Price Negotiation Act of 2007 H.R. 1218 Medicare Prescription Drug and Improvement Act of 2007 H.R. 1521 Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D H.R. 118 To amend part D title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate prices for part D covered drugs for Medicare beneficiaries H.R. 2056 Medicare Part D Improvement Act of 2007 S. 1507 Access to Medicare Data Act of 2007 H.R. 1536 Prescription Coverage Now Act of 2007 S. 28 Generics First Act of 2007 H.R. 932 To amend part D of title XVIII of the Social Security Act to limit the monthly amount of prescription drug cost-sharing for full-benefit dual eligible individuals H.R. 2945 Medicare Advantage Truth in Advertising Act of 2007 S. 273 Prescription Drug and Health Improvement Act of 2007 S. 1102 Part D Equity for Low Income Seniors Act of 2007 S. 1108 Medicare Part D Outreach and Enrollment Enhancement Act of 2007 H.R. 2058 Helping Fill the Medicare Rx Gap Act of 2007 S. 1103 Helping Fill the Medicare Rx Gap Act of 2007 S. 1218 Medicare for All Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1102: Part D Equity for Low-Income Seniors Act S. 1103: Helping Fill the Medicare Rx Gap Act S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act H.R. 1663: Medicare Mental Health Modernization Act S.Con.Res. 21: Budget Resolution H.Con.Res. 99: Budget Resolution H.R. 1535: Children's Health First Act S. 895: Children's Health First Act S. 1224: Children's Health Insurance Program Reauthorization Act H.R. 2147: Healthy Kids Act S. 1701: TMA/Medicare Advantage S. 401: Keep Children Covered Act S. 1544: Medicare Quality Enhancement Act S. 1507: Access to Medicare Data Act S. 706: Medicare Advantage Stabilization Fund H.R. 4: Medicare Prescription Drug Price Negotiation Act S. 3: Medicare Prescription Drug Price Negotiation Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

to the late enrollment penalty, creating a Medicare operated prescription drug plan, prescription drug price negotiations, repealing cost containment provisions, Medicare Advantage stabilization fund and comparative cost adjustment demonstration projects under the Medicare Modernization Act (P.L. 108-173), liberalizing asset test limits, reducing the benefit gap and guaranteeing prescription drug benefits. 3) H.R. 2945: providing beneficiary protections against excessive cost-sharing under the Medicare Advantage Program. 4) S. 242, H.R. 380: pertaining to the importation of prescription drugs. 5) H.R. 1571, H.R. 1663, S. 1715: eliminating discriminatory copayment rates for outpatient psychiatric services under the Medicare Program. 6) S. 1340, H.R. 2244: to provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. 7) S. 316, S. 1088, H.R. 1432, H.R. 1902: pertaining to market exclusivity for generic drugs. 8) S. 1102, S. 1103, S. 1107, S. 1108, H.R. 470, H.R. 932, H.R. 1536, H.R. 2058: improving prescription drug benefits for low-income beneficiaries under Medicare Part D. 9) S. 1082: amendments pertaining to citizen petitions to the Federal Drug Administration relating to generic drugs and to importation of prescription drugs under the Medicare program. 10) H.R. 2591: limiting the penalty for late enrollment under Medicare Part B. 11) H.R. 2009: repealing the Medicare cost containment provisions of the Medicare Modernization Act (P.L. 108-173). 12) H.R. 2307: protecting seniors from abusive marketing scams in Medicare Advantage. 13) H.R. 749: establishing health care vouchers for seniors. 14) S. 173, S. 1019, H.R. 2639: pertaining to Medicare Savings Accounts. 15) S. 464, S. 465, S. 466: pertaining to advance directives and end-of-life planning. Medicare. 1) H.R. 4, H.R. 118, S. 3, S. 273: pertaining to the negotiation of prescription drug prices under Medicare Part D. 2) H.R. 205, H.R. 1218, H.R. 1310, H.R. 1521, H.R. 2056, H.R. 2065, H.R. 2149, H.R. 3025, H.R. 3061, S. 250, S. 706: provisions relating

Client expense: $4,860,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1102 Part D Equity for Low-Income Seniors Act S. 1103 Helping Fill the Medicare Rx Gap Act S. 1224 Children’s Health Insurance Program Reauthorization Act S. 1507 Access to Medicare Data Act S. 1544 Medicare Quality Enhancement Act S. 1701 TMA\Medicare Advantage S. 3 Medicare Prescription Drug Price Negotiation Act of 2007 H.R. 4 Medicare Prescription Drug Price Negotiation Act of 2007 S.Con Res 21 Setting forth the congressional budget for the United States Government for fiscal year 2008 and including the appropriate budgetary levels for fiscal years 2007 and 2009 through 2012. H. Con Res 99 Concurrent Resolution on the Budget for Fiscal Year 2008 H.R. 1535 Children’s Health First Act H.R. 2147 Healthy Kids Act S. 401 Keep Children Covered Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1308, Legal Immigrant Children's Health Improvement Act of 2007, to amend title XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State Children's Health Insurance Program. S. 1224, Children's Health Insurance Program Reauthorization Act of 2007, to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. H.R., 1536 Prescription Coverage Now Act of 2007, to amend part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1102, Part D Equity for Low-Income Seniors Act of 2007, to amend title XVIII of the Social Security Act to expedite the application and eligibility process for low-income subsidies under the Medicare prescription drug program and to revise the resource standards used to determine eligibility for an income-related subsidy, and for other purposes. S. 1103, Helping Fill the Medicare Rx Gap Act of 2007, to amend title XVIII of the Social Security Act to include costs incurred by the Indian Health Service, a Federally qualified health center, an AIDS drug assistance program, certain hospitals, or a pharmaceutical manufacturer patient assistance program in providing prescription drugs toward the annual out of pocket threshold under part D of the Medicare program. S. 1107, Home and Community Services Copayment Equity Act of 2007, to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S. 1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007, to amend title XVIII of the Social Security Act to provide a special enrollment period for individuals who qualify for an income-related subsidy under the Medicare prescription drug program and to provide funding for the conduct of outreach and education with respect to the premium and cost-sharing subsidies under such program, and for other purposes. S. 751, Guaranteed Access to Medicaid for Newborns Act of 2007, to amend title XIX of the Social Security Act to modify certain administrative eligibility rules relating to children born in the United States to Medicaid-eligible mothers. S. 543, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007, to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S. 895, Children's Health First Act, to amend titles XIX and XXI of the Social Security Act to ensure that every child in the United States has access to affordable, quality health insurance coverage, and for other purposes. H.R. 1535, Children's Health First Act, to amend titles XIX and XXI of the Social Security Act to ensure that every child in the United States has access to affordable, quality health insurance coverage, and for other purposes. S. 450, Medicare Access to Rehabilitation Services Act of 2007, to amend title XVIII of the Social Security Act to repeal the medicare outpatient rehabilitation therapy caps. H.R. 748, Medicare Access to Rehabilitation Services Act of 2007, to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 2147, Healthy Kids Act of 2007, to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. S. 401, Keep Children Covered Act of 2007, to amend title XXI of the Social Security Act to eliminate funding shortfalls for the State Children's Health Insurance Program for fiscal year 2007. S. 3, Medicare Prescription Drug Price Negotiation Act of 2007, to amend part D of title XVIII of the Social Security Act to provide for fair prescription drug prices for Medicare beneficiaries. H.R. 4, Medicare Prescription Drug Price Negotiation Act of 2007, to amend part D of title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate lower covered part D drug prices on behalf of Medicare beneficiaries. Comments RE: REF:CMS-1533-P Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment System and Fiscal Year 2008 Payment Rates; Proposed Rule. S. 764, Legal Immigrant Children's Health Improvement Act of 2007, to amend title XIX and XXI of the Social Security Act to permit states the option of coverage of legal immigrants under the Medicaid Program and the State Children's Health Insurance Program.

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

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

LONG TERM CARE LONG TERM CARE H.R.1340 LONG TERM CARE H.R.1476 LONG TERM CARE H.R.1536 LONG TERM CARE H.R.1783 LONG TERM CARE H.R.6197 LONG TERM CARE H.R.1476 LONG TERM CARE H.R.1536 LONG TERM CARE H.R.1783 LONG TERM CARE H.R.6197 MEDICAID MEDICARE MEDICARE REFORM H.R.1536 MEDICARE REFORM H.R.4 MEDICARE REFORM H.R.1536 MEDICARE REFORM H.R.4 MEDICARE REFORM H.R.1536 MEDICARE REFORM H.R.4 MEDICARE REFORM S.3 MEDICARE REFORM S.3 MEDICARE REFORM S.3 MEDICARE REFORM S.3 MEDICARE H.R.1536 MEDICARE H.R.1536 MEDICARE H.R.4 MEDICARE H.R.1536 MEDICARE H.R.4 MEDICARE H.R.1536 MEDICARE H.R.4 MEDICARE PL108-173 MEDICARE PL108-173 MEDICARE S.1102 MEDICARE S.1932 MEDICARE S.3 MEDICARE S.1932 MEDICARE S.1102 MEDICARE S.3 MEDICARE S.3

Client expense: $7,400,000 · Firm income: Not reported

Government targets: Administration on Aging, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office