State Fiscal Relief Act of 2008

Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (Medicare Improvement for Patients and Providers Act of 2008, H.R.6331, S.3101;CHAMP Act, H.R.3162;Preserving Access to Medicare Act of 2008,S.3118;Inpatient Medicare Prospective Payment System Rule, CMS 1390-P,F;Medicare Recovery Audit Contractor Program Moratorium Act of 2007, H.R.4105;Nursing and Allied Health Education Preservation Act of 2008;H.R.5174;Registered Nurse Safe Staffing Act of 2007, H.R.4138;42CFR413.75,H.R.1093,provisions related to Medicare graduate medical education and the counting of resident work hours, HR 615 & 616 relating to Medicare Parity; PATH Act of 2008 (S.3656, HR 7241) Medicaid reimbursement issues (Iraq War Supplemental Appropriations Bill, H.R. 2642-Provision to Place Moratoria on Medicaid Regulations CMS-2258-FC,CMS 2279-P,CMS 2213-P, and CMS-2275-F; Protecting the Medicaid safety Net Act of 2008, H.R.5613;Public and Teaching Hospital Preservation Act, H.R.3533;Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2007, H.R.2066;Temporary Increase in FMAP (HR5268,S.2586, H.R.7110, S. 3656,S.3689 ) Medicaid Outpatient Regulation (ms 2213-F)

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

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

HR 7110 - Job Creation and Unemployment Relief Act of 2008, state fiscal relief, Medicaid, Child Support Enforcement HRes 1507 - Rule for consideration of HR 7110 S 3604 - Emergency supplemental appropriations for economic recovery HR 5268, S 2586, S 2819 - State Fiscal Relief HR 5613 - Medicaid Regulation Moratorium HR 2233, S 1871 - Unemployment Insurance Modernization Reid/Byrd Economic Recovery Act of 2008, state fiscal relief, Medicaid, Child Support Enforcement

Client expense: $510,000 · Firm income: Not reported

S 2819 - Economic Recovery in Health Care Act of 2008 HR 5268, S 2586 - State Fiscal Relief/increase in FMAP HR 7110 - Job Creation and Unemployment Relief Act of 2008, state fiscal relief, Medicaid, Child Support Enforcement HRes 1507 - rule for consideration of HR 7110 S 3604 - Emergency supplemental appropriations for economic recovery Medicaid Outpatient Hospital regulation HR 6331, S 3101 - Improving Medicare; improving stewardship of public funds over Medicaid Advantage plans S 1070, HR 1783 - Elder Justice Act HR 3078, S 1577 - Patient Safety and Abuse Prevention Act of 2007 HR 5613 - Protecting the Medicaid Safety Net, Medicaid Regulation Moratorium Reid/Byrd Economic Recovery Act of 2008, state fiscal relief, Medicaid, Child Support Enforcement Medicaid waiver transparency legislation

Client expense: $510,000 · Firm income: Not reported

S 2819 - Economic Recovery in Health Care Act of 2008 - fiscal relief for states HR 5268, S 2586 - State Fiscal Relief/increase in FMAP HR 7110 - Job Creation and Unemployment Relief Act of 2008 - fiscal relief for states HRes 1507 - Rule for consideration of HR 7110 S 3604 - Emergency supplemental appropriations for economic recovery HR 1424 - Emergency Economic Stabilization Act HR 5613 - Medicaid Regulation Moratorium S 380, HR 17 - Secure Rural Schools Act Reid/Byrd Economic Recovery Act of 2008, state fiscal relief, Medicaid, Child Support Enforcement

Client expense: $510,000 · Firm income: Not reported

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Regulation on State Rehabilitation Option--opposed regulation To provide for a temporary increase in the Federal Medical Assistance Percentage, and for other purposes--supported FMAP increase (H.R. 5268) A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Resolution Designating the week beginning September 8, 2008, as National Direct Support Professionals Recognition Week(S.Res. 613)--supported resolution Empowered at Home Act of 2008: aimed at removing existing barriers to the new Medicaid Section 1915(i) HCBS benefit, strengthening HCBS services in order to prevent or decrease the likelihood of institutionalization, provide state assistance to facilitate HCBS sevices, improve purchase of long term care, and improve CMS collection of state data regarding number of individuals, expenditures, types of services, and waiting lists. S. 3327 would increase income eligibility from current 150% of FPL to 300% of SSI; eliminate option to waive statewideness; expand scope of services to include "other services", and eliminate option to limit number of eligible individuals and extends time period for eligibility (S. 3327)--supported bill

Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (Medicare Improvement for Patients and Providers Act of 2008, H.R.6331, S.3101;CHAMP Act, H.R.3162;Preserving Access to Medicare Act of 2008, S.3118;Inpatient Medicare Prospective Payment System Rule, CMS 1390-P,F;Medicare Recovery Audit Contractor Program Moratorium Act of 2007, H.R.4105;Nursing and Allied Health Education Preservation Act of 2008;H.R.5174;Registered Nurse Safe Staffing Act of 2007, H.R.4138;42 CFR 413.75,H.R.1093,provisions related to Medicare graduate medical education and the counting of resident work hours,HR 615 & 616 relating to Medicare Parity Medicaid reimbursement issues (Iraq War Supplemental Appropriations Bill, H.R.2642-Provision to Place Moratoria on Medicaid Regulations CMS-2258-FC,CMS 2279-P,CMS 2213-P, and CMS-2275-F;Protecting the Medicaid Safety Net Act of 2008, H.R.5613;Public and Teaching Hospital Preservation Act, H.R.3533;Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2007, H.R.2066;Temporary Increase in FMAP (HR5268, S.2586, H.R.7110, S. 3656)

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

Supported all provisions unless otherwise indicated: BOTH SENATE AND HOUSE: S. 2620, H.R. 5268, To provide a temporary increase of the Federal medical assistance percentage (FMAP) under the Medicaid program and for other purposes Supported all provisions unless otherwise indicated: BOTH SENATE AND HOUSE: S. 3101, H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 2102, H.R. 154, Ending the Medicare Disabaility Waiting Period Act of 2007 S. 3560, QI [Qualified Individuals] Program Supplemental Funding Act of 2008 H.R. 7110, Job Creation and Unemployment Relief Act of 2008 - supported provisions related to temporary FMAP increase SENATE ONLY: S. 2586, State Fiscal Relief Act of 2008, provisions relating to providing a temporary FMAP increase, freezing the Medicaid regulations and for other purposes S. 2819, Economic Recovery in Health Care Act of 2008 S.J. Res. 44, A Joint Resolution for Congressional Disapproval of the Rule Set Forth as Requirements Contained in the August 17, 2007, Letter to State Health Officials from the Director of the Center for Medicaid and State Operations ... HOUSE ONLY: H.R. 5613, Protecting the Medicaid Safety Net Act of 2008

Client expense: Not reported · Firm income: Not reported

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Guidance on SCHIP income eligibility for program--opposed guidance CMS Regulation on State Rehabilitation Option--opposed regulation A bill to provide a temporary increase in Federal Medical Assistance Percentage (S. 2620 and H.R. 5268)--supported FMAP increase A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Resolution Designating the week beginning September 8, 2008, as National Direct Support Professionals Recognition Week(S.Res. 613)--supported resolution

Supported all provisions unless otherwise indicated: S. 2578, H.R. 5173, To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services - both Senate and House Supported all provisions unless otherwise indicated: S. 2620, H.R. 5268, To provide a temporary increase of the Federal medical assistance percentage (FMAP) under the Medicaid program and for other purposes - both Senate and House S. 3101, H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 - both Senate and House S. 1200, Indian Health Care Improvement Act Amendments of 2008, supported Klobuchar-Coleman amendment on Medicaid regulations regarding target case management - Senate only S. 2586, State Fiscal Relief Act of 2008, provisions relating to providing a temporary FMAP increase, freezing the Medicaid regulations and for other purposes - Senate only S. 2819, Economic Recovery in Health Care Act of 2008 - Senate only H.R. 5613, Protecting the Medicaid Safety Net Act of 2008 - House only

Client expense: $15,000 · Firm income: Not reported

HR 2642, "Supplemental Appropriations Act, 2008", Extension of Unemployment Benefits, Moratoria on Medicaid Regulations; S.Amendment 4803, Extension of Unemployment Benefits and Moratoria on Medicaid Regulations; S.Amendment 4196, Estate Tax Reform; S.Con.Res 70, "Budget Resolution FY 2009", tax provisions; S.2586 "State Fiscal Relief Act of 2008"; fiscal relief to states from increase of the Federal medical assistance percentage under the Medicaid program and direct payments to states; H.R. 5268, "To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes." Increase to states of the Federal medical assistance percentage under the Medicaid Program, increase in state fiscal assistance.

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2586, State Fiscal Relief Act of 2008 (regarding state fiscal relief) H.R. 5613, Protecting the Medicaid Safety Net Act of 2008 S. 2819, Economic Recovery in Health Care Act of 2008 (regarding Medicaid regulations, state fiscal relief and the August 17th SCHIP directive) H.R.5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes. S. 3101, Medicare Improvements for Patients and Providers Act of 2008 (provisions related to private-fee-for-service, low-income Medicare improvements, and extension of TMA) H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 (provisions related to private-fee-for-service, low-income Medicare improvements, and extension of TMA) H.R.2642, Emergency Supplemental Appropriations Act, 2008 (provisions related to Medicaid Regulations and the August 17th SCHIP directive)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Guidance on SCHIP income eligibility for program--opposed guidance CMS Regulation on State Rehabilitation Option--opposed regulation CMS Regulation on (Targeted) Case Management--opposed regulation CMS Regulation on Public Provider taxes--opposed regulation A bill to provide a temporary increase in Federal Medical Assistance Percentage (S. 2620 and H.R. 5268)--supported FMAP increase A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill

Supported all provisions unless otherwise indicated: S. 2578, H.R. 5173, to temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services - both Senate and House Supported all provisions unless otherwise indicated: S. 2620, H.R. 5268, to provide a temporary increase of the federal medical assistance percentage under the Medicaid program, and for other purposes - both Senate and House S. 1200, Indian Health Care Improvement Act Amendments of 2008, supported Klobuchar-Coleman amendment on Medicaid regulations regarding target case management - Senate only S. 2586, State Fiscal Relief Act of 2008 - Senate only

Client expense: $10,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3995 - Protecting the interests of residents in intermediate care facilities for the mentally retarded (ICF/MRs) HR 5613 - Protecting the Medicaid Safety Net Act of 2008, Medicaid Regulations Moratorium, all provisions HR 5268, S 2586 - State Fiscal Relief, increase in FMAP, Medicaid fiscal stimulus, all provision SConRes 70, HConRes 312 - Budget Resolution, Medicaid regulations, FMAP Grassley Amdt to S Con Res 70 - Medicaid regulation reserve fund (Reducing overpayments to) Medicare Advantage Plans S 2641 - Improving nursing home quality and staffing HR 3932, S 2219 - Medicare Prescription Drug Savings & Choice Act of 2007 Centers for Medicare & Medicaid Services regulations which shift costs onto states, hospitals and other providers S AMDT 4023 to S 1200 - Targeted Case Management regulation HR 4, S 3 - Medicare Prescription Drug Price Negotiations Program Revisions

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

S.Con.Res. 70, H.Con.Res. 312 - Budget Resolution - Medicaid regulations, FMAP HR 5268, S 2586 - State Fiscal Relief, increase in FMAP

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

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

HR 5268, S 2586 - State Fiscal Relief, increase in FMAP S.Con.Res. 70, H.Con.Res. 312 - Budget resolution - Medicaid regulations, FMAP, domestic discretionary funding Pandemic Influenza and emergency preparedness HR 2638, S 1644, HR 2764 - Homeland Security Appropriations, all provisions FY 2009 Agriculture appropriations, increased funding for nutrition programs HR 5140 - Economic Stimulus legislation, funds to states/localities: flexible grants, Medicaid, unemployment benefit HR 3074, HR 2764 - FY 2008 Transportation, Housing and Urban Development appropriations, CDBG formula grants, Public Housing Operating Fund, Public Housing Capital Fund, Resident Opportunities and Supportive Services S 1745 - Commerce, Justice, Science Related Agencies appropriations - Byrne-JAG formula funding, COPS, Juvenile Justice, State Criminal Alien Assistance Program (SCAAP), Bureau of Justice Statistics, Coastal and Estuarine Land Conservation Program HR 2829 - Financial Services, General Government appropriations - IRS budget, IRS' spending on private collection agencies, all provisions State, Foreign Operations, Related Agencies appropriations - East-West Center, all provisions HR 3222, HR 2764 - FY 2008 Supplemental Appropriations Act - Byrne-JAG funding, all provisions HR 3043, HR 2764, S 1710 - Labor-HHS-Education FY 2009 Appropriations - increased funding in all departments, Child Care block grant, Headstart funding, 9-11 health, education

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

S. 2586, State Fiscal Relief Act of 2008 (regarding state fiscal relief) H.R. 5613, Protecting the Medicaid Safety Net Act of 2008 S. 2819, Economic Recovery in Health Care Act of 2008 H.R.5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes. S.2460/H.R. 3533, To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S. 2578/ H.R. 5173, To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services. S.1200, A bill to amend the Indian Health Care Improvement Act to revise and extend the Act (provisions relating to Medicaid ID requirements and moratorium on targeted case management regulations) HR 4355, A bill to impose a moratorium on certain Medicaid payment restrictions. H.R. 3963, Childrens Health Insurance Program Reauthorization Act of 2007 (veto override)

Client expense: $120,376 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2586, Rockefeller, To provide States with fiscal relief through a temporary increase in the Federal medical assistance percentage and direct payments to States.; S.2578, To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services. S.2460, To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a rule regarding graduate medical education under Medicaid and to include a moratorium on the finalization of the outpatient Medicaid rule making similar changes; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; HR 5613 Protecting the Medicaid Safety Net Act of 2008, To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; HR 5173, To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services; HR 4355, To impose a moratorium on certain Medicaid payment restrictions; HR 3533, The Public and Teaching Hospital Preservation Act, To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a Medicaid rule regarding graduate medical education; Congressman Artur Davis Sign On Letter increasing state medicaid funding; medicaid rule changes.

Client expense: Not reported · Firm income: $10,000

HR 5268/S 2586 - temporary increase in federal Medicaid match - for HR 1621, Community Choice Act, allows nursing home eligible individuals to access community-based attendant services under Medicaid - for HR 3784 - Long-Term Care Quality Improvement Act - requires separate reporting of staffing expenditures on nursing homes' Medicare cost reports - for HR 5613, to impose and extend moratoria on Medicaid regulations on targeted case management and intergovernmental transfers for

Client expense: $87,982 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE