Nursing Home Transparency and Improvement Act of 2008

"Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2009; Proposed Rule" (CMS 1534P, 05/07/2008). S. 3101, "Medicare Improvements for Patients and Providers Act of 2008;" Section 141 "Extension of Exceptions Process for Medicare Therapy Caps." S. 2041, "False Cliams Act Correction Act of 2007" H.R. 4854, "False Claims Act Correction Act of 2007" S. 2641, "Nursing Home Transparency and Improvement Act of 2008" H.R. 6126, "Fairness in Nursing Home Arbitration Act of 2008"

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

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

Medicare/Medicaid rates; Medicare & Medicaid reimbursement rates; Improving Medicare beneficiary access (75% Rule); Nursing Home Quality Healthcare; Children's Health Insurance Program (CHIP) Reauthorization Act of 2007; CMS drug rates. S. 2641: Nursing Home Transparency and Improvement Act of 2008; H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162 - Children's Health and Medicare Protection Act of 2007 - Section 502, provisions related to payment for inpatient rehabilitation facilities. Section 502, provisions related to payment for skilled nursing facility payment updates. S. 1893 - Children's Health Insurance Program legislation, skilled nursing facility payment issues. S. 2641 - Nursing Home Transparency and Improvement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162 - Children's Health and Medicare Protection Act of 2007 - Section 502, provisions related to payment for inpatient rehabilitation facilities. Section 502, provisions related to payment for skilled nursing facility payment updates. H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008 S. 1893 - Children's Health Insurance Program legislation, skilled nursing facility payment issues. S. 2838 - Fairness in Nursing Home Arbitration Act of 2008 S. 2641 - Nursing Home Transparency and Improvement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Information Technology; Health Care Reform; SCHIP - H.R. 2; Nursing Home Reform - S. 2641; Nursing Home Fairness - S. 2838

Client expense: $353,531 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tracking of federal Medicare legislation (e.g., H.R. 6331/S. 3101 - Medicare Improvements for Patients and Providers Act). S.2838/H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008. S. 2641 - Nursing Home Transparency and Improvement Act of 2008. Reform of the Federal Stafford Act (e.g. H.R. 7054).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tracking of federal Medicare legislation (e.g., H.R. 6331/S. 3101 - Medicare Improvements for Patients and Providers Act). S.2838/H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008. S. 2641 - Nursing Home Transparency and Improvement Act of 2008. Reform of the Federal Stafford Act (e.g. H.R. 7054).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tracking of federal Medicare legislation (e.g., H.R. 6331/S. 3101 - Medicare Improvements for Patients and Providers Act). S.2838/H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008. S. 2641 - Nursing Home Transparency and Improvement Act of 2008. Reform of the Federal Stafford Act (e.g. H.R. 7054).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

Client expense: Not reported · Firm income: $30,000

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

Client expense: Not reported · Firm income: $30,000

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Employee Free Choice Act of 2007 (H.R. 800, S. 1041); Nursing Home Transparency and Improvement Act of 2008 (S.2641); Medicare and Medicaid funding; H.R. 6331 (Medicare Improvements for Patients and Providers Act of 2008); Long-term care reform; Fairness in Nursing Home Arbitration Act of 2008 (H.R. 6126, S. 2838); Resource utilization group recalibration included in the SNF PPS.

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

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

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

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

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

H.R.7128 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.7110 - Making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for the fiscal year ending September 30, 2009, and for other purposes. H.R. 2807 - To intensify stem cell research showing evidence of substantial clinical benefit to patients, and for other purposes. H.R. 1783 - To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, & for other purposes. H.R. 2521 - To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1046 - To amend titles XI and XVIII of the Social Security Act to modernize the quality improvement organization (QIO) program. H.R.1841 - To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R.4082 - To improve the quality of, and access to, long-term care. H.R.3784 - To amend title XVIII of the Social Security Act to improve the quality of care in skilled nursing facilities under the Medicare Program through requiring the reporting of expenditures for nursing. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.4854 - To amend the provisions of title 31, United States Code, relating to false claims to clarify and make technical amendments to those provisions, and for other purposes. H.R.3453 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding demonstration project for clinical laboratory services. H.R.3180 - To amend title 31, United States Code, to clarify who is an original source for purposes of bringing a qui tam action. H.R. 5480 - To repond to a Medicare funding warning. H.R.6337 - To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.5878 - To authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. H.R.2705 - To amend the Compact of Free Association Amendments Act of 2003, and for other purposes. H.R.6252 - To amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. H.R. 5799 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.Res.1203 - Expressing support for designation of the week beginning May 11, 2008, as "National Nursing Home Week". S.Res.543 - A resolutioni designating the week beginning May 11, 2008, as "National Nursing Home Week". S. 2641 - A bill to amend title XVII and XIX of the Social Security Act to improve the transparenct of information on skilled nursing facilities and nursing facilities and to clarift and improce the targeting of the enforcement of requitements with respect to such facilities. S. 1980 - A bill to improve the quality of, and access to, long-term care. S. 2662 - A bill to respond to a Medicare funding warning. S. 2041 - A bill to amend the False Claims Act. S. 1693 - A bill to enhance the adoption of a nationwide interoperable health information technology system and to improce the quality and reduce the costs of health care in the United States. S. 1947 - A bill to amend title XI of the Social Security Act to improve the quality improvement organization (QIO) program. S. 2099 - A bill to amend title XVII of teh Social Security Act to repeal the medicare competitive bidding project for clinical laboratory services. S. 1070 - A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S. 1019 - A bill to provide comprehensive reform of the health care system of the United States, and for other purposes. S. 1814 - A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiabel information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights. S. 1615 - A bill to provide loans and grants for fire sprinkler retrofitting in nursing facilities. S. 845 - A bill to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls. S. 334 - A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. S. 325 - A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S. 1980 - A bill to improve the quality of, and access to, long-term care. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S. 3144 - A bill to amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.2603 - A bill to amend title XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare program and to increase the amount of the surety bond required for suppliers of durable medical equipment. S.2641- A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.1424 - A bill to provide authority for the Federal Government to purchase and insure certain types of troubled assets for the purposes of providing stability to and preventing disruption in the economy and financial system and protecting taxpayers, to amend the Internal Revenue Code of 1986 to provide incentives for energy production and conservation, to extend certain expiring provisions, to provide individual income tax relief, and for other purposes. H.R. 5268 H.R. 5613 H.R. 6331 S. 2820

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Improvements in Military compensation and benefits. S.38,S.67,S.206,S.439,S.604,S.648,S.773,S.935,S.986,S.1002,S.1200,S.1243,S.1547,S.1606,S.2052,S.2273,S.2383,S.2400 S.2573,S.2599,S.2639,S.2641,S.2689,S.2796,S.2797,S.2799,S.2824,S.2836,S.2838,S.2863,S.2889,S.2921,S.2926,S.2937,S.2963, S.2984,S.3001,S.3057,S.3073,S.3101,S.3230,S.3621,SCONRES70, S28, S.2377,HR82,HR303,HR327,HR333,HR579,HR599 HR440,HR657,HR690,HR704,HR737,HR784,HR992,HR1023,HR1102,HR1110,HR1223,HR1428,HR1436,HR1439, HR1593,HR1927,HR2027,HR2319,HR2638,HR2642,HR2682,HR2721,HR2889,HR3026,HR3174,HR4089,HR4255 HR4463,HR5481,HR5604,HR5658,HR5729,HR5825,HR5826,HR5832,HR5925,HR5441,HR6930,HR6070,HR3221 HR7011,HR5658,HR5888,HR440,HR82,HR3038

Client expense: $408,526 · Firm income: Not reported

Government targets: Air Force, Dept of, Army, Dept of (Other), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA)

1. H.R. 1669/S. 982, "Positive Aging Act of 2007". Support all provisions. The bill would improve access to mental health services for older adults by integrating mental health services into primary and community settings through demonstration projects that target urban and rural medically underserved areas. Interdisciplinary teams of mental health professionals working in collaboration wiht other providers of health care and social services would provide these evidence-based services. 2. H.R. 1424, the "Paul Wellstone Mental Health and Addiction Equity Act" - Support all provisions. The bill expands the Mental Health Parity Act of 1996 by requiring group health plans that offer benefits for mental health and addiction to do so on the same terms as care for other diseases. 3. H.R. 2502, "Geriatricians Loan Forgiveness Act of 2007". Support all provisions. The bill would extend the National Health Service Corps Loan Repayment Program to geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training to obtain a certificate of added qualifications in geriatric medicine or geriatric psychiatry. 4. S. 558, the "Mental Health Parity Act of 2007". Support provisions to prohibit private health insurance plans from imposing treatment limitations or financial requirements on mental health benefits unless comparable limitations or requirements are imposed on medical and surgical benefits. 5. Discussed with House and Senate staff the need to include older adults in clinical trials, following the 2007 release of a GAO report on this issue. 6. S. 1628, a bill to amend the Public Health Service Act to authorize programs to increase the number of nurse faculty and to increase the domestic nursing and physical therapy workforce. Support all provisions. 7. S. 1854, the "Stop Senior Suicide Act". Support provisions to repeal the 50 percent Medicare outpaitent mental health coinsurance rate; improve interagency coordination; provide grants for elderly suicide early intervention and prevention strategies; and enhance the existing Suicide Prevention Resource Center. 8. Support H. R. 3411, the "Juvenile Crime Reduction Act of 2007," to provide strategies to help to decrease the prevalence of young people with mental disorders who come into contact with the juvenile justice system. 9. S. 2708 and H.R. 6337, the "Caring for an Aging America Act of 2008. Support all provisions. The bill would provide for the establishment of a new geriatric and gerontology loan repayment program. 10. Reauthorization of the Substance Abuse and Mental Health Services Administration - discuss inclusion of provisions from S. 982 (the "Positive Aging Act of 2007") and S. 1854 (the "Stop Senior Suicide Act") with Senate staff. 11. Discussed with House and Senate staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. 12. Support S. 2641, the "Nursing Home Transparency and Improvement Act of 2008". Support all provisions. The bill would increase public transparency and accountability of nursing home owners and operators, including nursing home chains, by requiring them to disclose the corporate entities that own nursing homes and their affiliated entities. 13. Support H.R. 6375, "Healthy Transitions Act". Support all provisions. The bill would establish planning and implementation grants to states to assist in the development of a coordinated service delivery system to maximize continuity of care and access to services for young adults who are transitioning to the adult mental health system. 14. Support H.R. 1424, Emergency Economic Stabilization Act of 2008". Support provision to provide mental health parity to require group health plans that offer mental health and substance abuse benefits to do so on the same terms as medical and surgical benefits. 15. S. 3335, the "Jobs, Eneergy, Families and Disaster Relief Act of 2008". Support mental health parity provision. 16. S. 3155, a bill to reauthorize the "Juvenile Justice and Delinquency Prevention Act of 1974". Urge that the bill include provisions to address the plight to young people with mental disorders intersecting with the juvenile justice system. 17. S. 3730, the "Retooling the Health Care Workforce for an Aging America Act of 2008". Support all provisions. This bill addresses the current and future shortage of health care personnel who are trained to care for older adults.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2641, The Nursing Home Transparency and Improvemtn Act of 2008, sections 101, 106, 201, 202 and 203. S. 1980 & H.R. 4080, Long-term Care Quality and Modernization Act of 2007 H.R. 6357, The Protecting Records, Optimizing Treatment and Easing Communication through Healthcare Technology Act of 2008 H.R. 4859, The False Claims Correction Act 2007, Sections 2, 3, 5-7

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

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

Medicare Improvements for Patients and Providers Act (HR. 6331); Nursing Home Transparency and Improvement Act of 2008 (S. 2641). Medicaid regulations passed as part of the War Supplemental Appropriations Act (HR. 2642).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare/Medicaid rates; Medicare & Medicaid reimbursement rates; Improving Medicare beneficiary access (75% Rule); Nursing Home Quality Healthcare; Children's Health Insurance Program (CHIP) Reauthorization Act of 2007; CMS drug rates. S. 2641: Nursing Home Transparency and Improvement Act of 2008; H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tracking of federal Medicare legislation (e.g., H.R. 6331/S. 3101 - Medicare Improvements for Patients and Providers Act). S.2838/H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008. S. 2641 - Nursing Home Transparency and Improvement Act of 2008. Reform of the Federal Stafford Act (e.g. H.R. 7054).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tracking of federal Medicare legislation (e.g., H.R. 6331/S. 3101 - Medicare Improvements for Patients and Providers Act). S.2838/H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008. S. 2641 - Nursing Home Transparency and Improvement Act of 2008. Reform of the Federal Stafford Act (e.g. H.R. 7054).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tracking of federal Medicare legislation (e.g., H.R. 6331/S. 3101 - Medicare Improvements for Patients and Providers Act). S.2838/H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008. S. 2641 - Nursing Home Transparency and Improvement Act of 2008. Reform of the Federal Stafford Act (e.g. H.R. 7054).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

"Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2009; Proposed Rule" (CMS 1534P, 05/07/2008). S. 3101: "Medicare Improvements for Patients and Providers Act of 2008"; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps." H.R. 6331: "Medicare Improvements for Patients and Providers Act of 2008" ; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps." S. 3118: "Preserving Access to Medicare Act of 2008"; Section 139 "Extension of Exceptions Process for Medicare Therapy Caps." S. 3118: "Preserving Access to Medicare Act of 2008"; Section 105. S. 2041: "False Claims Act Correction Act of 2007." H.R. 4854: "False Claims Act Correction Act of 2007." S.2641: "Nursing Home Transparency and Improvement Act of 2008." H.R. 6126: "Fairness in Nursing Home Arbitration Act of 2008."

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2009; Proposed Rule (CMS 1534P, 05/07/2008). Changes for Long Term Care Hospitals Required by Certain Provisions of the Medicare, Medicaid, SCHIP Extension Act of 2007 (CMS-1493-IFC2, 05/22/2008). Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2009; and Revisions to the Amendment of the E-Prescribing Exemption for Computer Generated Facsimile Transmissions; Proposed Rule (CMS-1403-P, 07/07/2008) S. 3101: "Medicare Improvements for Patients and Providers Act of 2008" ; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps" H.R. 6331: "Medicare Improvements for Patients and Providers Act of 2008" ; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps" S. 3118: "Preserving Access to Medicare Act of 2008"; Section 139 "Extension of Exceptions Process for Medicare Therapy Caps" S. 3118: "Preserving Access to Medicare Act of 2008"; Section 105 H.R. 2642: "Supplemental Appropriations Act, 2008"; Section 7001 "Moratoria on Certain Medicaid Regulations" S.2041: "False Claims Act Correction Act of 2007" H.R. 4854: "False Claims Act Correction Act of 2007" S.2641: "Nursing Home Transparency and Improvement Act of 2008" H.R. 6126: "Fairness in Nursing Home Arbitration Act of 2008"

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

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

Healthy Families (S 910, HR 1542); Nursing Home Fairness (S 2838); Health IT (S 1693, HR 3800, HR 6357); Small Business Health Options (HR 6210); Stimulus (S 3604, HR 7110); Bankruptcy Bill (HR 1424); Empowered at Home Act (S 3327, HR 7212); Nursing Home Transparency Act (S 2641, HR 7128)

Client expense: $475,204 · Firm income: Not reported

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

H.R.7128 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.7110 - Making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for the fiscal year ending September 30, 2009, and for other purposes. H.R. 2807 - To intensify stem cell research showing evidence of substantial clinical benefit to patients, and for other purposes. H.R. 1783 - To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, & for other purposes. H.R. 2521 - To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1046 - To amend titles XI and XVIII of the Social Security Act to modernize the quality improvement organization (QIO) program. H.R.1841 - To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R.4082 - To improve the quality of, and access to, long-term care. H.R.3784 - To amend title XVIII of the Social Security Act to improve the quality of care in skilled nursing facilities under the Medicare Program through requiring the reporting of expenditures for nursing. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.4854 - To amend the provisions of title 31, United States Code, relating to false claims to clarify and make technical amendments to those provisions, and for other purposes. H.R.3453 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding demonstration project for clinical laboratory services. H.R.3180 - To amend title 31, United States Code, to clarify who is an original source for purposes of bringing a qui tam action. H.R. 5480 - To repond to a Medicare funding warning. H.R.6337 - To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.5878 - To authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. H.R.2705 - To amend the Compact of Free Association Amendments Act of 2003, and for other purposes. H.R.6252 - To amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. H.R. 5799 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.Res.1203 - Expressing support for designation of the week beginning May 11, 2008, as "National Nursing Home Week". S.Res.543 - A resolutioni designating the week beginning May 11, 2008, as "National Nursing Home Week". S. 2641 - A bill to amend title XVII and XIX of the Social Security Act to improve the transparenct of information on skilled nursing facilities and nursing facilities and to clarift and improce the targeting of the enforcement of requitements with respect to such facilities. S. 1980 - A bill to improve the quality of, and access to, long-term care. S. 2662 - A bill to respond to a Medicare funding warning. S. 2041 - A bill to amend the False Claims Act. S. 1693 - A bill to enhance the adoption of a nationwide interoperable health information technology system and to improce the quality and reduce the costs of health care in the United States. S. 1947 - A bill to amend title XI of the Social Security Act to improve the quality improvement organization (QIO) program. S. 2099 - A bill to amend title XVII of teh Social Security Act to repeal the medicare competitive bidding project for clinical laboratory services. S. 1070 - A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S. 1019 - A bill to provide comprehensive reform of the health care system of the United States, and for other purposes. S. 1814 - A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiabel information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights. S. 1615 - A bill to provide loans and grants for fire sprinkler retrofitting in nursing facilities. S. 845 - A bill to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls. S. 334 - A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. S. 325 - A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S. 1980 - A bill to improve the quality of, and access to, long-term care. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S. 3144 - A bill to amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.2603 - A bill to amend title XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare program and to increase the amount of the surety bond required for suppliers of durable medical equipment. S.2641- A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.1424 - A bill to provide authority for the Federal Government to purchase and insure certain types of troubled assets for the purposes of providing stability to and preventing disruption in the economy and financial system and protecting taxpayers, to amend the Internal Revenue Code of 1986 to provide incentives for energy production and conservation, to extend certain expiring provisions, to provide individual income tax relief, and for other purposes.

Client expense: $390,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

1. H.R. 1669/S. 982, "Positive Aging Act of 2007". Support all provisions. The bill would improve access to mental health services for older adults by integrating mental health services into primary and community settings through demonstration projects that target urban and rural medically underserved areas. Interdisciplinary teams of mental health professionals working in collaboration wiht other providers of health care and social services would provide these evidence-based services. 2. H.R. 1424, the "Paul Wellstone Mental Health and Addiction Equity Act" - Support all provisions. The bill expands the Mental Health Parity Act of 1996 by requiring group health plans that offer benefits for mental health and addiction to do so on the same terms as care for other diseases. 3. H.R. 2502, "Geriatricians Loan Forgiveness Act of 2007". Support all provisions. The bill would extend the National Health Service Corps Loan Repayment Program to geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training to obtain a certificate of added qualifications in geriatric medicine or geriatric psychiatry. 4. S. 558, the "Mental Health Parity Act of 2007". Support provisions to prohibit private health insurance plans from imposing treatment limitations or financial requirements on mental health benefits unless comparable limitations or requirements are imposed on medical and surgical benefits. 5. Discussed with House and Senate staff the need to include older adults in clinical trials, following the 2007 release of a GAO report on this issue. 6. S. 1628, a bill to amend the Public Health Service Act to authorize programs to increase the number of nurse faculty and to increase the domestic nursing and physical therapy workforce. Support all provisions. 7. S. 1854, the "Stop Senior Suicide Act". Support provisions to repeal the 50 percent Medicare outpaitent mental health coinsurance rate; improve interagency coordination; provide grants for elderly suicide early intervention and prevention strategies; and enhance the existing Suicide Prevention Resource Center. 8. Support H. R. 3411, the "Juvenile Crime Reduction Act of 2007," to provide strategies to help to decrease the prevalence of young people with mental disorders who come into contact with the juvenile justice system. 9. S. 2708 and H.R. 6337, the "Caring for an Aging America Act of 2008. Support all provisions. The bill would provide for the establishment of a new geriatric and gerontology loan repayment program. 10. Reauthorization of the Substance Abuse and Mental Health Services Administration - discuss inclusion of provisions from S. 982 (the "Positive Aging Act of 2007") and S. 1854 (the "Stop Senior Suicide Act") with Senate staff. 11. Discussed with House and Senate staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. 12. Support S. 2641, the "Nursing Home Transparency and Improvement Act of 2008". Support all provisions. The bill would increase public transparency and accountability of nursing home owners and operators, including nursing home chains, by requiring them to disclose the corporate entities that own nursing homes and their affiliated entities. 13. Support H.R. 6375, "Healthy Transitions Act". Support all provisions. The bill would establish planning and implementation grants to states to assist in the development of a coordinated service delivery system to maximize continuity of care and access to services for young adults who are transitioning to the adult mental health system. 14. Support H.R. 1424, Emergency Economic Stabilization Act of 2008". Support provision to provide mental health parity to require group health plans that offer mental health and substance abuse benefits to do so on the same terms as medical and surgical benefits. 15. S. 3335, the "Jobs, Eneergy, Families and Disaster Relief Act of 2008". Support mental health parity provision. 16. S. 3155, a bill to reauthorize the "Juvenile Justice and Delinquency Prevention Act of 1974". Urge that the bill include provisions to address the plight to young people with mental disorders intersecting with the juvenile justice system.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1032, the "Alzheimer's Treatment and Caregiver Support Act"; and S. 2641, the "Nursing Home Transparancy and Improvement Act of 2008"

Client expense: $22,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1758/H.R. 3001 - CLASS Act, to establish a national insurance trust for long-term care - for S. 2708/HR 6337 - Caring for an Aging America Act, to recruit and retain health professionals for the field of long-term care - for S 2641/HR 5799, Nursing Home Transparency and Improvement Act - for requirements on reporting nursing home ownership and staffing. Opposed to provisions for increased penalties for survey deficiencies. HR 7128, Nursing Home Transparency and Quality of Care Improvement Act - for requirements on reporting nursing home ownership and staffing. Opposed to provisions for increased penalties for survey deficiencies.

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162 - Children's Health and Medicare Protection Act of 2007 - Section 502, provisions related to payment for inpatient rehabilitation facilities. Section 502, provisions related to payment for skilled nursing facility payment updates. S. 1893 - Children's Health Insurance Program legislation, skilled nursing facility payment issues. S. 2641 - Nursing Home Transparency and Improvement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162 - Children's Health and Medicare Protection Act of 2007 - Section 502, provisions related to payment for inpatient rehabilitation facilities. Section 502, provisions related to payment for skilled nursing facility payment updates. H.R. 6126 - Fairness in Nursing Home Arbitration Act of 2008 S. 1893 - Children's Health Insurance Program legislation, skilled nursing facility payment issues. S. 2838 - Fairness in Nursing Home Arbitration Act of 2008 S. 2641 - Nursing Home Transparency and Improvement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

Client expense: Not reported · Firm income: $30,000

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

Client expense: Not reported · Firm income: $30,000

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Employee Free Choice Act of 2007 (H.R. 800, S. 1041); Nursing Home Transparency and Improvement Act of 2008 (S.2641); Medicare and Medicaid funding; H.R. 6331 (Medicare Improvements for Patients and Providers Act of 2008); Long-term care reform; Fairness in Nursing Home Arbitration Act of 2008 (H.R. 6126, S. 2838); Resource utilization group recalibration included in the SNF PPS.

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

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

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

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

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

S. 2641, The Nursing Home Transparency and Improvement Act, as it pertains to the regulation of nursing facilities

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6126, H. Rept. 110-894, S. 2838, S. Rept. 110-190 Fairness in Nursing Home Arbitration Act-all provisions S. 1577, S. Rept. 110-474 Patient Safety and Abuse Prevention Act of 2007-all provisions S. 2641, HR 5799 Nursing Home Transparency Improvement Act-all provisions

Client expense: Not reported · Firm income: $18,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Improvements in Military compensation and benefits. S.38,S,67,S.206,S.439,S.604,S.648,S.773,S.935,S.986,S.1002,S.1200,S.1243,S.1547,S.1606,S.2052,S.2273,S2377,S.2383,S.2400,S.2573,S.2599,S.2639,S.2641,S.2689,S.2796,S.2797,S.2799,S.2824,S.2836,S.2838,S.2863,S.2889,S.2921,S.2926,S.2937,S.2963,S.2984,S.3001,S.3057,S.3101,S.3621,SCONRES70,S.28,HR81,HR82,HR303,HR327,HR333,HR579,HR599,HR657,HR690, HR704,HR737,HR784,HR992,HR1023,HR1102,HR1110,HR1223,HR1428,HR1436,HR1439,HR1593,HR1927,HR2027,HR2319,HR2638,HR2642,HR2682,HR2721,HR2889,HR3026,HR3038,HR3174,HR4089,HR4255,HR4463,HR5481,HR5604,HR5658,HR5729,HR5825,HR5826,HR5832,HR5925,HR5441,HR6930,HR6070,HR3221,HR7011,HR5658,HR5888

Client expense: $429,304 · Firm income: Not reported

Government targets: Air Force, Dept of, Army, Dept of (Other), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA)

1. S. 2641, Nursing Home Transparency and Improvement Act of 2008, entire bill 2. S. 1758, Community Living Assistance Services and Supports Act, entire bill 3. S. 2838, Fairness in Nursing Home Arbitration Act, entire bill 4. H.R. 3001, Community Living Assistance Services and Supports Act, entire bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

"Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2009; Proposed Rule" (CMS 1534P, 05/07/2008). S. 3101: "Medicare Improvements for Patients and Providers Act of 2008" ; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps." H.R. 6331: "Medicare Improvements for Patients and Providers Act of 2008" ; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps." S. 3118: "Preserving Access to Medicare Act of 2008"; Section 139 "Extension of Exceptions Process for Medicare Therapy Caps." S. 3118: "Preserving Access to Medicare Act of 2008"; Section 105. S. 2041: "False Claims Act Correction Act of 2007." H.R. 4854: "False Claims Act Correction Act of 2007." S.2641: "Nursing Home Transparency and Improvement Act of 2008."

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2009; Proposed Rule (CMS 1534P, 05/07/2008). Changes for Long Term Care Hospitals Required by Certain Provisions of the Medicare, Medicaid, SCHIP Extension Act of 2007 (CMS-1493-IFC2, 05/22/2008). Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2009; and Revisions to the Amendment of the E-Prescribing Exemption for Computer Generated Facsimile Transmissions; Proposed Rule (CMS-1403-P, 07/07/2008) S. 3101: "Medicare Improvements for Patients and Providers Act of 2008" ; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps" H.R. 6331: "Medicare Improvements for Patients and Providers Act of 2008" ; Section 141 "Extension of Exceptions Process for Medicare Therapy Caps" S. 3118: "Preserving Access to Medicare Act of 2008"; Section 139 "Extension of Exceptions Process for Medicare Therapy Caps" S. 3118: "Preserving Access to Medicare Act of 2008"; Section 105 H.R. 2642: "Supplemental Appropriations Act, 2008"; Section 7001 "Moratoria on Certain Medicaid Regulations" S.2041: "False Claims Act Correction Act of 2007" H.R. 4854: "False Claims Act Correction Act of 2007" S.2641: "Nursing Home Transparency and Improvement Act of 2008"

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

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

Medicare Improvements for Patients and Providers Act (HR. 6331); Nursing Home Transparency and Improvement Act of 2008 (S. 2641). Medicaid regulations past as part of the War Supplemental Appropriations Act (HR. 2642).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. H.R. 1669/S. 982, "Positive Aging Act of 2007". Support all provisions. The bill would improve access to mental health services for older adults by integrating mental health services into primary and community settings through demonstration projects that target urban and rural medically underserved areas. Interdisciplinary teams of mental health professionals working in collaboration wiht other providers of health care and social services would provide these evidence-based services. 2. H.R. 1424, the "Paul Wellstone Mental Health and Addiction Equity Act" - Support all provisions. The bill expands the Mental Health Parity Act of 1996 by requiring group health plans that offer benefits for mental health and addiction to do so on the same terms as care fo rother diseases. 3. H.R. 2502, "Geriatricians Loan Forgiveness Act of 2007". Support all provisions. The bill would extend the National Health Service Corps Loan Repayment Program to geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training to obtain a certificate of added qualifications in geriatric medicine or geriatric psychiatry. 4. S. 558, the "Mental Health Parity Act of 2007". Support provisions to prohibit private health insurance plans from imposing treatment limitations or financial requirements on mental health benefits unless comparable limitations or requirements are imposed on medical and surgical benefits. 5. Discussed with House and Senate staff the need to include older adults in clinical trials, following the 2007 release of a GAO report on this issue. 6. S. 1628, a abill to amend the Public Health Service Act to authorize programs to increase the number of nurse faculty and to increase the domestic nursing and physical therapy workforce. Support all provisions. 7. S. 1854, the "Stop Senior Suicide Act". Support provisions to repeal the 50 percent Medicare outpaitent mental health coinsurance rate; improve interagency coordination; provide grants for elderly suicide early intervention and prevention strategies; and enhance the existing Suicide Prevention Resource Center. 8. Support H. R. 3411, the "Juvenile Crime Reduction Act of 2007," to provide strategies to help to decrease the prevalence of young people with mental disorders who come into contact with the juvenile justice system. 9. S. 2708 and H.R. 6337, the "Caring for an Aging America Act of 2008. Support all provisions. The bill would provide for the establishment of a new geriatric and gerontology loan repayment program. 10. Reauthorization of the Substance Abuse and Mental Health Services Administration - discuss inclusion of provisions from S. 982 (the "Positive Aging Act of 2007") and S. 1854 (the "Stop Senior Suicide Act") with Senate staff. 11. Discussed with House and Senate staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. 12. Support S. 2641, the "Nursing Home Transparency and Improvement Act of 2008". Support all provisions. The bill would increase public transparency and accountability of nursing home owners and operators, including nursing home chains, by requiring them to disclose the corporate entities that own nursing homes and their affiliated entities. 13. Co-hosted Capitol Hill briefing for House and Senate staff members on mental health needs of older adults, including the need fo rmore geriatric health specialists, the need to integrate mental health care with primary care and the need for parity for Medicare outpatient mental health services.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare/Medicaid rates; Medicare & Medicaid reimbursement rates; Improving Medicare beneficiary access (75% Rule); Nursing Home Quality Healthcare; Children's Health Insurance Program (CHIP) Reauthorization Act of 2007; CMS drug rates. S. 2641: Nursing Home Transparency and Improvement Act of 2008; H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare/Medicaid rates; Medicare & Medicaid reimbursement rates; Improving Medicare beneficiary access (75% Rule); Nursing Home Quality Healthcare; Children's Health Insurance Program (CHIP) Reauthorization Act of 2007; CMS drug rates. S. 2641: Nursing Home Transparency and Improvement Act of 2008; H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE