A bill to provide for a temporary increase of the Federal medical assistance percentage under the Medicaid program, and for other purposes.

HR 3162, Children's Health and Medicare Protection Act of 2007, all provisions relating to comparative effectiveness research, Medicare (including Medicare Advantage), Medicaid, and SCHIP; HR 2639, Promoting Health for Future Generations Act of 2007, all provisions relating to Medicare Advantage Medical Savings Accounts; S 2499, Medicare, Medicaid, and SCHIP Extension Act of 2007, all provisions relating to Medicare (including Medicare Advantage and Medicare Secondary Payor), Medicaid, and SCHIP; HR 5613, Protecting the Medicaid Safety Net Act of 2008, all provisions relating to CMS regulatory action on Medicaid; S 2620, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes; all provisions relating to Medicaid payment; HR 5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes; all provisions relating to Medicaid payment; S 1701, To provide for the extension of transitional medical assistance (TMA) and the abstinence education program through the end of fiscal year 2007, and for other purposes; provisions relating to Medicare Advantage; HR 5480, Medicare Funding Warning Response Act of 2008, all provisions relating to Medicare (including Medicare Advantage), health information technology, and health care quality measurement; S 2662, Medicare Funding Warning Response Act of 2008, all provisions relating to Medicare (including Medicare Advantage), health information technology, and health care quality measurement; HR 976, Children's Health Insurance Program Reauthorization Act of 2007, all provisions relating to children's health and dental insurance coverage; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007, all provisions relating to children's health and dental insurance coverage; HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act, 2007, all provisions relating to SCHIP funding; S 334/ HR 3163, Healthy Americans Act, all provisions relating to health insurance coverage, Medicare, Medicaid, SCHIP, and employer taxes related to health insurance; Medicare Advantage Payment; Medicaid payment and state plans oversight; SCHIP reauthorization; S.3101 - Medicare Improvement for Patients and Providers Act of 2008; HR 6331 - Medicare Improvement for Patients and Providers Act of 2008; HR 6819 To ammend the Medicare Improvement for Patients adn Providers act, all provisions related to the Medicare Advantage program

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

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

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 Disability 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 HOUSE ONLY: H.R. 5613, Protecting the Medicaid Safety Net Act of 2008 H.R. 6684, Medicare Prescription Drug Cost Equalization Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.458 Physician Pathology Continuity Act, S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas H.R. 6357 Protecting Records, Optimizing Treatment and Easing Communications through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Services Continuity Act, S. 558 The Mental Health Parity Act of 2007, S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act, S.969 Oppose Reversal of NLRB guidance on when charge nurses are classifed as supervisors, S.1041 Employee Free Choice Act-Oppose Card Check process, S.1604 Nursing Education and Quality of Health Care Act of 2007, S.1693 Health Information Exchange, S.2041 The False Claims Act Correction Act of 2007, S.2460 Extend S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers, S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007, S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP, S.3101 The Medicare Improvements for Patients and Providers Act S.3656 Preserving Access to Healthcare (PATH) Act of 2008 H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.2638 Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 continuing resolution 2009 H.R.2642, supplemental appropriations Act, 2008 H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5480 Medicare Funding Warning Response Act of 2008 H.R.5613 Extend and Establish Moratorium on Medicaid Rules H.R.5924 Emergency Nursing Supply Relief Act H.R.6331 Physician Medicare payment relief H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology H.R.6898 Health-e IT Act of 2008 H.R.7067 Quality FIRST Act of 2008 H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision H.R.7219 The Protecting Hospital Outpatient and Community Clinic Services Act of 2008 H.R.7241 Preserving Access to Healthcare (PATH) Act of 2008 H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas

Client expense: Not reported · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act-Oppose Card Check process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on medicaid regulations affecting intergovernmental transfers; S.2499 Medicare, medicaid, and SCHIP extension act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and establish moratorium on Medicaid rules; increase FMAP; S.3101 the Medicare improvements for patients and providers act; S.3656 Preserving access to healthcare (PATH) act of 2008; H.R.800 Employee free choice act (oppose card check process); H.R.866 Secret ballot protection act; H.R.976 Children's health insurance reauthoriation act of 2007; H.R.1105 Physician pathology services continuity act; H.R.1177 Sole commuunity hospital preservation act; H.R.1424 Paul Wellstone mental health and addiction equity act of 2007; H.R.1644 Oppose reversal of NLRB quidance on when charge nurses are classified as supervisors; H.R.1663 Medicare mental health modernization act of 2007; H.R.2159 Rural health services preservation act; H.R.2406 establishes NIST role in standard setting for health IT; H.R.2638 Consolidated security, disaster assistance, and continuing appropriations act, 2009; Continuing resolution 2009; H.R.2642 Supplemental appropriations act, 2008; H.R.3162 Children health and Medicare protection act of 2007; H.R.3326 Early treatment for HIV act; H.R.3533 Public and teaching hospital preservation Act; H.R.4105 One-year moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5480 Medicare funding warning response act of 2008; H.R.5613 Extend and establish moratorium on Medicaid rules; H.R.5924 Emergency nursing supply relief act; H.R.6331 Physician Medicare payment releif; H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology; H.R.6898 Health-E IT Act of 2008; H.R.7067 Quality FIRST Act of 2008; H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision; H.R.7219 the Protecting Hospital and outpatient and community clinic services act of 2008; H.R.7241 Preserving access to health care (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare prescription drug improvement and modernization act of 2003; FFY 2009 budget and budget resolutions/Medicare and Medicaid cuts; FFY 2009 Labor, health and human services, education and pension appropriations bill; FFY 2009 Medicare Inpatient hospital PPS rules; CY 2009 Medicare inpatient Psychiatric facility PPS rules; FFY 2009 Medicare inpatient rehabiltiation facility PPS and "75% rule," rules; CY 2009 Medicare otupatient PPS rules; FFY 2009 Medicare skilled nursing facility PPS rules; CY 2009 Medicare home health agency PPS rules; CY 2009 Medicare physician fee schedule update; CMS proposed rule to limit intergovernmental transfers and certified public expenditures; CMS proposed value-based purchasing program; CMS proposed rule on Medicad graduate medical education payments; State childrens health insurance program funding; IRS Form 990 revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; pay for performance/value based purchasing; health information technology; hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductibel health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; mental health parity; Limited service hospitals; Department of Housing and Urban Development's federal housing assistance mortage program for hospitals; Defiend benefit pension plans; National Institute of Health funding; Health care workforce recruting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340b drug pricing program; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; CMS directive to states establishing new requirements for increasing SCHIP coverage; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: $240,000 · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Medicare Reimbursement; Illinois Hospital Assessment Program; Sustainable Growth Rate/Physician Fee Schedule Fix; Hospital Compare Data; H.R. 1845/S. 1428, Medicare Durable Medical Equipment Access Act; H.R. 621, Home Oxygen Patient Protection Act; Medicare Moratoriums and H.R. 5613, Protecting the Medicare Safety Act of 2008; H.R. 5268/S. 2620, providing temporary increase in Federal Matching Assistance Percentage; H.R. 6331, The Medicare Improvements for Patients and Provider Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7110, Job Creation and Unemployment Relief Act of 2008; making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for fiscal year ending September 30, 2009 and other purposes; in support of provisions relating to a temporary increase in the federal medical assistance percentage under the Medicaid program; Title III Temporary increase in the Medicaid Match Rate. S. 3604, National Park Centennial Fund Act; A bill making emergency supplemental appropriations for economic recovery for the fiscal year ending September 30, 2008; in support of provisions relating to a temporary increase in the federal medical assistance percentage under the Medicaid program; Title III State Fiscal Relief, Section 3001, Temporary Increase in Medicaid FMAP. H.R. 976/ H.R. 3963, Children's Health Insurance Program Reauthorization Act of 2007; In support of all provisions. H.R. 5268/ S. 2620, To provide for a temporary increase in the federal medical assistance percentage under the Medicaid program, and for other purposes; In support of all provisions.

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

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

Medicare Reimbursement; Illinois' Hospital Assessment Program; Sustainable Growth Rate/Physician Fee Schedule Fix; Hospital Compare Data; H.R. 1845/S. 1428, Medicare Durable Medical Equipment Access Act; H.R. 621, Home Oxygen Patient Protection Act; Medicare Moratoriums and H.R. 5613, Protecting the Medicare Safety Act of 2008; H.R. 5268/S. 2620, providing temporary increase of Federal Matching Assistance Percentage; H.R. 6331, The Medicare Improvements for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 3/ HR 4 - Medicare Prescription Drug Price Negotiation Act of 2007 SCHIP Reauthorization Medicaid Regulations/Moratoria Federal Medical Assistance Percentage Increase HR 3533- The Public and Teaching Hospital Preservation Act HR 4355 - To impose a moratorium on certain Medicaid payment restrictions HR 5268/S 2620- To provide for a temporary increase of the Federal Medical Assistance Percentage under the Medicaid Program, and for other purposes

Client expense: $34,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), 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

H.R. 7219, Protecting Hospital Outpatient and Community Clinic Services Act of 2008 H.R. 7110, Job Creation and Unemployment Relief Act of 2008 S. 3604, S. 3688, S. 3689, Economic Recovery Act of 2008 H.R. 7067, Quality First Act H.R. 7241 and S. 3656, Preserving Access to Healthcare (PATH) Act of 2008 H.R. 5268 and S. 2620, To Provide a Temporary FMAP Increase H.R. 676, United States Health Insurance Act H.R. 6898, Health e-information Technology Act of 2008 Baucus/Grassley Value-Based Purchasing Draft Bill

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

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

Lobbyed for inclusion of Title III, Section 3001 of the National Park Centennial Fund Act -S.3689, relating to the increase in the federal match to the states for Medicaid. H.R.7110, Job Creation and Unemployment Relief Act of 2008; making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for fiscal year ending September 30, 2009 and other purposes; in support of provisions relating to a temporary increase in the federal medical assistance percentage under the Medicaid program; Title III Temporary increase in the Medicaid Match Rate. H.R.976/H.R.3963, Childrens Health Insurance Program Reauthorization Act of 2007; In support of all provisions. H.R.5268/S.2620, To provide for a temporary increase in the federal medical assistance percentage under the Medicaid program, and for other purposes; In support of all provisions.

Client expense: Not reported · Firm income: $31,500

Government targets: Centers For Medicare and Medicaid Services (CMS), Council of Economic Advisers (CEA), HOUSE OF REPRESENTATIVES, SENATE

Discussions re Medicare and Medicaid Issues, Medicare Improvement Bill to Provide for a Temporary Increase of the Federal medical assistance percentage (FMAP), S. 2620 Medicare Improvements for Patients and Providers Act of 2008, H.R. 6331 Bill to Provide for Temporary Increase of the Federal medical assistance percentage (FMAP), H.R. 5268

Client expense: $420,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), SENATE, U.S. Trade Representative (USTR)

HR 3162, Children's Health and Medicare Protection Act of 2007, all provisions relating to comparative effectiveness research, Medicare (including Medicare Advantage), Medicaid, and SCHIP; HR 2639, Promoting Health for Future Generations Act of 2007, all provisions relating to Medicare Advantage Medical Savings Accounts; S 2499, Medicare, Medicaid, and SCHIP Extension Act of 2007, all provisions relating to Medicare (including Medicare Advantage and Medicare Secondary Payor), Medicaid, and SCHIP; HR 5613, Protecting the Medicaid Safety Net Act of 2008, all provisions relating to CMS regulatory action on Medicaid; S 2620, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes; all provisions relating to Medicaid payment; HR 5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes; all provisions relating to Medicaid payment; S 1701, To provide for the extension of transitional medical assistance (TMA) and the abstinence education program through the end of fiscal year 2007, and for other purposes; provisions relating to Medicare Advantage; HR 5480, Medicare Funding Warning Response Act of 2008, all provisions relating to Medicare (including Medicare Advantage), health information technology, and health care quality measurement; S 2662, Medicare Funding Warning Response Act of 2008, all provisions relating to Medicare (including Medicare Advantage), health information technology, and health care quality measurement; HR 976, Children's Health Insurance Program Reauthorization Act of 2007, all provisions relating to children's health and dental insurance coverage; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007, all provisions relating to children's health and dental insurance coverage; HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act, 2007, all provisions relating to SCHIP funding; S 334/ HR 3163, Healthy Americans Act, all provisions relating to health insurance coverage, Medicare, Medicaid, SCHIP, and employer taxes related to health insurance; Medicare Advantage Payment; Medicaid payment and state plans oversight; SCHIP reauthorization; S.3101 - Medicare Improvement for Patients and Providers Act of 2008; HR 6331 - Medicare Improvement for Patients and Providers Act of 2008; HR 6819 To ammend the Medicare Improvement for Patients adn Providers act, all provisions related to the Medicare Advantage program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, 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

Medicare Reimbursement; Medicare funding; Sustainable Growth Rate/Physician Fee Schedule Fix; Hospital Compare Data; H.R. 1845/S. 1428, Medicare Durable Medical Equipment Access Act; H.R. 621, Home Oxygen Patient Protection Act; Medicare Moratoriums and H.R. 5613, Protecting the Medicare Safety Act of 2008; H.R. 5268/S. 2620, providing temporary increase of Federal Matching Assistance Percentage; H.R. 6331, The Medicare Improvements for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6331/S.3101, Medicare Improvement for Patients and Providers Act of 2008; In support of provisions relating to Special Needs Plans, Sec. 164, Revisions relating to Specialized Medicare Advantage Plans for Special Needs Individuals. H.R.6365, Medicare Special Needs Plans Extension and Amendments Act of 2008; In support of all provisions. H.R.7110, Job Creation and Unemployment Relief Act of 2008; making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for fiscal year ending September 30, 2009 and other purposes; in support of provisions relating to a temporary increase in the federal medical assistance percentage under the Medicaid program; Title III Temporary increase in the Medicaid Match Rate. S.3604, National Park Centennial Fund Act; A bill making emergency supplemental appropriations for economic recovery for the fiscal year ending September 30, 2008; In support of provisions relating to a temporary increase in the federal medical assistance percentage under the Medicaid program; Title III State Fiscal Relief, Section 3001, Temporary Increase in Medicaid FMAP. H.R.976/H.R.3963, Childrens Health Insurance Program Reauthorization Act of 2007; In support of all provisions. H.R.5268/S.2620, To provide for a temporary increase in the federal medical assistance percentage under the Medicaid program, and for other purposes; In support of all provisions.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), 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) (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

HR 6331, Medicare Improvements for Patients and Providers Act - for provisions to renew therapy caps exceptions process HR 5268/S 2620 - temporary increase in federal Medicaid matching funds - for HR 3784, requiring separate reporting of staffing expenditures on nursing homes' Medicare cost reports - for S 799/HR 1621, Community Choice Act, allowing Medicaid coverage of community-based attendant services - for S 3327, Empowered at Home Act, to improve Medicaid coverage of adult day services - for

Client expense: $100,140 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act-Oppose Card Check process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on medicaid regulations affecting intergovernmental transfers; S.2499 Medicare, medicaid, and SCHIP extension act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and establish moratorium on Medicaid rules; increase FMAP; S.3101 the Medicare improvements for patients and providers act; S.3656 Preserving access to healthcare (PATH) act of 2008; H.R.800 Employee free choice act (oppose card check process); H.R.866 Secret ballot protection act; H.R.976 Children's health insurance reauthoriation act of 2007; H.R.1105 Physician pathology services continuity act; H.R.1177 Sole commuunity hospital preservation act; H.R.1424 Paul Wellstone mental health and addiction equity act of 2007; H.R.1644 Oppose reversal of NLRB quidance on when charge nurses are classified as supervisors; H.R.1663 Medicare mental health modernization act of 2007; H.R.2159 Rural health services preservation act; H.R.2406 establishes NIST role in standard setting for health IT; H.R.2638 Consolidated security, disaster assistance, and continuing appropriations act, 2009; Continuing resolution 2009; H.R.2642 Supplemental appropriations act, 2008; H.R.3162 Children health and Medicare protection act of 2007; H.R.3326 Early treatment for HIV act; H.R.3533 Public and teaching hospital preservation Act; H.R.4105 One-year moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5480 Medicare funding warning response act of 2008; H.R.5613 Extend and establish moratorium on Medicaid rules; H.R.5924 Emergency nursing supply relief act; H.R.6331 Physician Medicare payment releif; H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology; H.R.6898 Health-E IT Act of 2008; H.R.7067 Quality FIRST Act of 2008; H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision; H.R.7219 the Protecting Hospital and outpatient and community clinic services act of 2008; H.R.7241 Preserving access to health care (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare prescription drug improvement and modernization act of 2003; FFY 2009 budget and budget resolutions/Medicare and Medicaid cuts; FFY 2009 Labor, health and human services, education and pension appropriations bill; FFY 2009 Medicare Inpatient hospital PPS rules; CY 2009 Medicare inpatient Psychiatric facility PPS rules; FFY 2009 Medicare inpatient rehabiltiation facility PPS and "75% rule," rules; CY 2009 Medicare otupatient PPS rules; FFY 2009 Medicare skilled nursing facility PPS rules; CY 2009 Medicare home health agency PPS rules; CY 2009 Medicare physician fee schedule update; CMS proposed rule to limit intergovernmental transfers and certified public expenditures; CMS proposed value-based purchasing program; CMS proposed rule on Medicad graduate medical education payments; State childrens health insurance program funding; IRS Form 990 revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; pay for performance/value based purchasing; health information technology; hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductibel health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; mental health parity; Limited service hospitals; Department of Housing and Urban Development's federal housing assistance mortage program for hospitals; Defiend benefit pension plans; National Institute of Health funding; Health care workforce recruting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340b drug pricing program; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; CMS directive to states establishing new requirements for increasing SCHIP coverage; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: $220,000 · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Continuity Act, S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas H.R. 6357 Protecting Records, Optimizing Treatment and Easing Communications through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB)

S 3/ HR 4 - Medicare Prescription Drug Price Negotiation Act of 2007 SCHIP Reauthorization Medicaid Regulations/Moratoria Federal Medical Assistance Percentage Increase HR 3533- The Public and Teaching Hospital Preservation Act HR 4355 - To impose a moratorium on certain Medicaid payment restrictions HR 5268/S 2620- To provide for a temporary increase of the Federal Medical Assistance Percentage under the Medicaid Program, and for other purposes HR 5613- Protecting the Medicaid Safety Net Act of 2008 HR 2642-Military Construction and Veterans Affairs Appropriations Act, 2008 HR 6331- Medicare Improvements for Patients and Providers Act of 2008

Client expense: $51,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors;S.1041 Employee Free Choice Act-Oppose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R. 800 Employee Free Choice Act-Oppose Card Check Process; H.r. 866 Secret Ballot Protection Act; H.R. 976 Children's Health Insurance Reauthorization Act of 2007; H.R. 1105 Physician Pathology Services Continuity Act; H.R. 1177 Sole Community Hospital Preservation Act; H.R. 1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R. 1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R. 1663 Medicare Mental Health Modernization Act of 2007; H.R. 2159 Rural Health Services Preservation Act; H.R. 2406 Establishes NIST Role in Standard Setting for Health IT; H.R. 2642 Supplemental Appropriations Act, 2008; H.R. 3162 Children's Health and Medicare Protection Act of 2007; H.R. 3326 Early Treatment for HIV Act; H.R. 3533 Public and Teaching Hospital Preservation Act; H.R. 4105 One-Year Moratorium on the Recovery Audit Contractor (RAC) Program; H.R. 4854 False Claims Act Correction Act of 2007; H.R. 5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R. 5613 Extend and Establish Moratorium on Medicaid Rules; HR. 6331 Physician Medicare Payment Relief; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations Bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule", Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/Value Based Purchasing; Health Information Technology; Hospital Charity Care/Financial Aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration, Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Development's Federal Housing Assistance Mortgage program for Hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas; S.3101 The Medicare Improvements for Patients and Providers Act; S.3656 Preserving Access to Healthcare (PATH) Act of 2008; H.R. 2638 Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 (continuing resolution 2009); H.R. 5480 Medicare Funding Warning Response Act of 2008; H.R. 5924 Emergency Nursing Supply Relief Act; H.R. 6898 Health-e IT Act of 2008; HR. 7067 Quality FIRST Act of 2008; H.R. 7110 Job Creation and Unemployment Relief Act of 2008 (Title III includes FMAP provision); H.R. 7219 The Protecting Hospital Outpatient and Community Clinic Services Act of 2008; H.R. 7241 Preserving Access to Healthcare (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Client expense: Not reported · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

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/ 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.6444/S.334: Healthy Americans Act S.2620, A bill to provide for a temporary increase of the Federal medical assistance percentage under the Medicaid program, and for other purposes S.3611, Medicaid Services Restoration Act of 2008

Client expense: $70,988 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Reimbursement; Medicare funding; Sustainable Growth Rate/Physician Fee Schedule Fix; Hospital Compare Data; H.R. 1845/S. 1428, Medicare Durable Medical Equipment Access Act; H.R. 621, Home Oxygen Patient Protection Act; Medicare Moratoriums and H.R. 5613, Protecting the Medicare Safety Act of 2008; H.R. 5268/S. 2620, providing temporary increase of Federal Matching Assistance Percentage; H.R. 6331, The Medicare Improvements for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free choice Act-Opose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R.800 Employee Free Choice Act Oppose Card Check process; H.R.866 Secret Ballot Protection Act; H.R.976 Childrens Health Insurance Reauthorization Act of 2007; H.R.1105 Physician Pathology Services Continuity Act; H.R.1177 Sole Community Hospital Preservation Act; H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R.1663 Medicare Mental Health Modernization Act of 2007; H.R.2159 rural Health Services Preservation Act; H.R.2406 Establishes NIST Role in Standard Setting for Health IT; H.R.2642, Supplemental Appropriations Act, 2008; H.R.3162 Children Health and Medicare Protection Act of 2007; H.R.3326 Early Treatment for HIV Act; H.R.3533 Public and Teaching Hospital Preservation Act; H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5613 Extend and Establish Moratorium on Medicaid Rules; H.R.6331 Physician Medicare payment relief; H.R.6357 Protecting records, optimizing treatment, and easing communication thorugh healthcare technology; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program funding; IRS Form 990 Revision; Stark and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance / value based purchasing; Health information technology; Hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/trigger; Medicare GME residency slot distribution; National Health Service Corp funding; Public Health Service Act nursing and allied health professions program funding; HRSAs health professions shortage areas and medically underserved areas.

Client expense: $190,000 · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

HR 3162, Children's Health and Medicare Protection Act of 2007, all provisions relating to comparative effectiveness research, Medicare (including Medicare Advantage), Medicaid, and SCHIP; HR 2639, Promoting Health for Future Generations Act of 2007, all provisions relating to Medicare Advantage Medical Savings Accounts; S 2499, Medicare, Medicaid, and SCHIP Extension Act of 2007, all provisions relating to Medicare (including Medicare Advantage and Medicare Secondary Payor), Medicaid, and SCHIP; HR 5613, Protecting the Medicaid Safety Net Act of 2008, all provisions relating to CMS regulatory action on Medicaid; S 2620, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes; all provisions relating to Medicaid payment; HR 5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes; all provisions relating to Medicaid payment; S 1701, To provide for the extension of transitional medical assistance (TMA) and the abstinence education program through the end of fiscal year 2007, and for other purposes; provisions relating to Medicare Advantage; HR 5480, Medicare Funding Warning Response Act of 2008, all provisions relating to Medicare (including Medicare Advantage), health information technology, and health care quality measurement; S 2662, Medicare Funding Warning Response Act of 2008, all provisions relating to Medicare (including Medicare Advantage), health information technology, and health care quality measurement; HR 976, Children's Health Insurance Program Reauthorization Act of 2007, all provisions relating to children's health and dental insurance coverage; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007, all provisions relating to children's health and dental insurance coverage; HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act, 2007, all provisions relating to SCHIP funding; S 334/ HR 3163, Healthy Americans Act, all provisions relating to health insurance coverage, Medicare, Medicaid, SCHIP, and employer taxes related to health insurance; Medicare Advantage Payment; Medicaid payment and state plans oversight; SCHIP reauthorization; S.3101 - Medicare Improvement for Patients and Providers Act of 2008; HR 6331 - Medicare Improvement for Patients and Providers Act of 2008

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

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

S.458 Physician Pathology Continuity Act, S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas H.R. 6357 Protecting Records, Optimizing Treatment and Easing Communications through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S 3/ HR 4 - Medicare Prescription Drug Price Negotiation Act of 2007 SCHIP Reauthorization Medicaid Regulations/Moratoria Federal Medical Assistance Percentage Increase HR 3533- The Public and Teaching Hospital Preservation Act HR 4355 - To impose a moratorium on certain Medicaid payment restrictions HR 5268/S 2620- To provide for a temporary increase of the Federal Medical Assistance Percentage under the Medicaid Program, and for other purposes HR 5613- Protecting the Medicaid Safety Net Act of 2008 HR 2642-Military Construction and Veterans Affairs Appropriations Act, 2008 HR 6331- Medicare Improvements for Patients and Providers Act of 2008

Client expense: $68,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors;S.1041 Employee Free Choice Act-Oppose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R. 800 Employee Free Choice Act-Oppose Card Check Process; H.r. 866 Secret Ballot Protection Act; H.R. 976 Children's Health Insurance Reauthorization Act of 2007; H.R. 1105 Physician Pathology Services Continuity Act; H.R. 1177 Sole Community Hospital Preservation Act; H.R. 1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R. 1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R. 1663 Medicare Mental Health Modernization Act of 2007; H.R. 2159 Rural Health Services Preservation Act; H.R. 2406 Establishes NIST Role in Standard Setting for Health IT; H.R. 2642 Supplemental Appropriations Act, 2008; H.R. 3162 Children's Health and Medicare Protection Act of 2007; H.R. 3326 Early Treatment for HIV Act; H.R. 3533 Public and Teaching Hospital Preservation Act; H.R. 4105 One-Year Moratorium on the Recovery Audit Contractor (RAC) Program; H.R. 4854 False Claims Act Correction Act of 2007; H.R. 5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R. 5613 Extend and Establish Moratorium on Medicaid Rules; HR. 6331 Physician Medicare Payment Relief; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations Bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule", Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/Value Based Purchasing; Health Information Technology; Hospital Charity Care/Financial Aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration, Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Development's Federal Housing Assistance Mortgage program for Hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: Not reported · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), 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

Client expense: $70,000 · Firm income: Not reported

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

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

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007;S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act Oppose Card Check process; S.1693 Health Information Exchange Act; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R.800 Employee Free Choice Act Oppose Card Check process; H.R.866 Secret Ballot Protection Act; H.R.976 Childrens Health Insurance Reauthorization Act of 2007; H.R.1105 Physician Pathology Services Continuity Act; H.R.1177 Sole Community Hospital Preservation Act; H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R.1663 Medicare Mental Health Modernization Act of 2007; H.R.2159 rural Health Services Preservation Act; H.R.2406 Establishes NIST Role in Standard Setting for Health IT; H.R.3162 Children Health and Medicare Protection Act of 2007; H.R.3326 Early Treatment for HIV Act; H.R.3533 Public and Teaching Hospital Preservation Act; H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5613 Extend and Establish Moratorium on Medicaid Rules; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program funding IRS Form 990 Revision; Stark and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance / value based purchasing; Health information technology; Hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/trigger; Medicare GME residency slot distribution; National Health Service Corp funding; Public Health Service Act nursing and allied health professions program funding; HRSAs health professions shortage areas and medically underserved areas.

Client expense: $220,000 · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), 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

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

See addendum. 1.S.242/H.R.380, the Pharmaceutical Market Access and Drug Safety Act of 2007, as related to provisions governing the importation of prescription drugs. 2.S.251, the Pharmaceutical Market Access Act of 2007, all provisions governing the importation of prescription drugs. 3.S. 484, the Enhancing Drug Safety and Innovation Act of 2007, all provisions related to the safety of prescription medicines. 4.S. 604, the Military Health Care Protection Act, as related to provider participation in the Department of Defense TRICARE program. 5.S. 980, Online Pharmacy Consumer Protection Act of 2007, as related to the regulation of online pharmacies. 6.S. 1200, Indian Health Care Improvement Act Amendments of 2007, all provisions related to reducing fraud and abuse in the Medicare program. 7.S. 1276/H.R.2747, the Methamphetamine Production Prevention Act of 2007, as related to the distribution of legal substances used in the production of methamphetamine. 8.S. 1693, the Wired for Health Care Quality Act of 2007, as related to improving health information technology. 9.S. 1695, the Biologics Price Competition and Innovation Act of 2007, as related to the approval of generic biopharmaceuticals. 10.S. 1827, Pharmacist Access and Recognition in Medicare (PhARM) Act of 2007 as related to provider participation in the Medicare program. 11.S.1915, Electronic Prescription Drug Act of 2007, as related to the regulation of electronic prescribing of pharmaceuticals 12.S.1951/H.R.3700, Fair Medicaid Drug Payment Act of 2007, as related to Medicaid provider reimbursement. 13.S.1954, Pharmacy Access Improvement (PhAIm) Act of 2007, as related to access standards to pharmacies. 14.S.2013/H.R.3090, Patient and Pharmacy Protection Act of 2007, as related to prescription requirements in the Medicaid program. 15.S.2071, Combat Methamphetamine Enhancement Act of 2007, as related to the distribution of legal substances used in the production of methamphetamine. 16.S.2274, Dextromethorphan Abuse Reduction Act of 2007, as related to steps to prevent the abuse of dextromethorphan. 17.S.2408/H.R.4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007, as related to the regulation of electronic prescribing of pharmaceuticals. 18.H.R.976, Small Business Tax Relief Act of 2007, all provisions associated with work-related tax credits. 19.H.R. 970, the Dextromethorphan Distribution Act of 2007, as related to steps to prevent the abuse of dextromethorphan. 20.H.R. 971/S.855, the Community Pharmacy Fairness Act of 2007, as related to provider negotiations in the Medicare program. 21.H.R.1038/S.623, Access to Life-Saving Medicine Act, as related to the approval of generic biopharmaceuticals. 22.H.R. 1474, the Fair and Speedy Treatment (FAST) of Medicare Prescription Drug Claims Act of 2007, as related to provider reimbursement in the Medicare program 23.H.R.1585/S.1548, National Defense Authorization Act for Fiscal Year 2008, as related to retail pharmacy participation in the Department of Defense TRICARE program. 24.H.R.1845, the Medicare Durable Medical Equipment Access Act of 2007, as related to provider inclusion in the Medicare Part B program. 25.H.R.1902, the Protecting Consumer Access to Generic Drugs Act of 2007, as related to the availability of generic pharmaceuticals. 26.H.R.2716, the Reducing Fraudulent and Imitation Drugs Act of 2007, as related to the safety of prescription drugs. 27.H.R. 2900, the Food and Drug Administration Amendments of 2007, all provisions related to prescription drug information and safety. 28.H.R.3109, the Dental Health Promotion Act of 2007, all provisions related to payment for health services. 29.H.R.3140, Saving Our Community Pharmacies Act of 2007, as related to Medicaid provider reimbursement. 30.H.R.3162, Children's Health and Medicare Protection Act of 2007, provisions related to health insurance in the Medicare program. 31.H.R.3193, Access to Community Pharmacy Preservation Act of 2007, as related to Medicaid provider reimbursement. 32.H.R.3580, Food and Drug Administration Amendments Act of 2007, all provisions related to prescription drug information and safety. 33.H.R.3610, Food and Drug Import Safety Act of 2007, provisions related to the safety of prescription drugs. 34.H.R.5268/S.2620, Temporary Increase of Medicaid FMAP, all provisions related to payments in the Medicaid program. 35.H.R.5480/S.2662, Medicare Funding Warning Response Act of 2008, all provisions related to provider access and payments in the Medicare program. 36.H.R.5491, Emilys Act, as related to the certification of pharmacy technicians. 37.H.R.5546, Credit Card Fair Fee Act of 2008, as related to fees associated with credit card purchase. 38.H.R.5613, Protecting the Medicaid Safety Net Act of 2008, all provisions related to provider participation in the Medicaid program. 39.H.R.5629, Pathway for Biosimilars Act, as related to the availability of generic pharmaceuticals. 40.H.Con.Res.312/S.Con.Res.70, Concurrent Resolution on the Budget for Fiscal Year 2009, all provisions related to healthcare providers and prescription drugs.

Client expense: $370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Defense, Dept of (DOD), 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), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), Office of Personnel Management (OPM), President of the U.S., SENATE

Medicare: Make permanent/extend NJ's imputed wage index floor, set to expire September 30th; Extension of Section 508 of the MMA of 2003, set to expire September 30th. Support H.R. 5426, a bill that would increase the floor on Direct Graduate Medical Education (DGME) payment over three years to 100 percent of the national per resident amount (PRA). Medicaid: Support extension of moratorium on the Medicaid public provider and graduate medical education (GME) rules, set to expire in May 2008. Support H.R. 5613, the Protecting the Medicaid Safety Net Act. The bill would extend until March 31, 2009, moratorium on several Medicaid regulations that would strip an estimated $20 billion over five years from the program, including certified public expenditures (CPE), intergovernmental transfers (IGT) and graduate medical education (GME) as well regulations affecting coverage of hospital outpatient services; state provider tax laws; coverage of rehab services for people with disabilities; outreach and enrollment in schools and specialized medical transportation to school for children covered by Medicaid; and case management services that allow people with disabilities to remain in the community. Support H.R. 3533/S.2460 that proposes to extend a moratorium that expires May 25 on regulations issued by the Centers for Medicare & Medicaid Services (CMS) affecting CPEs, IGTs, and GME. Support H.R. 5268/S.2620, a bill that would temporarily increase the Medicaid FMAP by 2.95 percent from April 1, 2008 through June 30, 2009, but states would be required to maintain their Medicaid eligibility at current levels to receive the increase.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician Pathology Services Continuity Act (S.458); Rural Health Services Preservation Act (S.630); Nursing Education and Quality of Health Care Act of 2007 (S.1604); Health Information Exchange (S.1693); Extend Moratorium on Medicaid Regulations Affecting Intergovernmental Transfers (S.2460); Medicare, Medicaid and SCHIP Extension Act of 2007 (S.2499); Temporary increase in Federal medical assistance percentages under Medicaid program (S.2620); Extend and Establish Moratorium on Medicaid Rules; increase FMAP (s.2819); Children's Health Insurance Reauthorization Act of 2007 (H.R.976); Medicare Mental Health Modernization Act of 2007 (H.R.1663); Rural Health Services Preservation Act (H.R.2159); One-Year Moratorium on the Recovery Audit Contractor (RAC) program (H.R.4105); Temporary increase in federal medical assistance percentages under Medicaid program (H.R.5268); Extend and Establish Moratorium on Medicaid Rules (H.R.5613); FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule"; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; Hospital pricing transparency; Not-for-Profit Hospital Tax-Exempt Status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/value based purchasing; Health information technology; Hospital charity care/financial aid; Associated health plans; Coverage for the uninsured; Emergency Preparedness; Medicare wage index; Mental health parity; Limited service hospitals; Dept. of Housing and Urban Development's Federal Housing Assistance mortgage program for hospitals; Defined benefit pension plans; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False Claims Act expansion; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: Not reported · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Medicare Reimbursement; Medicare funding; Sustainable Growth Rate/Physician Fee Schedule Fix; Hospital Compare Data; H.R. 1845/S. 1428, Medicare Durable Medical Equipment Access Act; H.R. 621, Home Oxygen Patient Protection Act; Medicare Moratoriums and H.R. 5613, Protecting the Medicare Safety Act of 2008; H.R. 5268/S. 2620, providing temporary increase of Federal Matching Assistance Percentage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.458 Physician Pathology Services Continuity Act, S.558 The Mental Health Parity Act of 2007,S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act,S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas

Client expense: $10,000 · 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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE