Save Medicare Act of 2008

H.R.477 Stroke Treatment & Ongoing Prevention Act H.R.583 Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 H.R.882 Access to Emergency Medical Services Act of 2007 H.R.1093 Resident Physician Shortage Reduction Act of 2007 H.R.1233 Mitigating the Impact of Uncompensated Services & Time Act of 2007 H.R.1418 Reauthorizations of the Traumatic Brain Injury Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.2050 Medicaid Emergency Psychiatric Care Act of 2007 H.R.2164 Medicare Ambulance Payment Extension Act H.R. 2406 Healthcare Information Technology Enterprise Integration Act H.R.2464 Wakefield Act H.R.2580 Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007 H.R.2583 Physician Workforce & Graduate Medical Education Enhancement Act of 2007 H.R.2584 High-need Physician Workforce Incentives Act of 2007 H.R.2626 Comprehensive Health Coverage and Reform Enhancement (CARE) Act of 2007 H.R.2749 Voluntary Medicare Quality Reporting Act H.R.3163 Healthy Americans Act H.R.3173 Improving Emergency Medical Care & Response Act of 2007 H.R.3344 Treat Physicians Fairly Act of 2007 H.R.3495 - Kids in Disasters Well-Being, Safety & Health Act of 2007 H.R.3533 Public and Teaching Hospital Preservation Act H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007 H.R.4736 To amend Part B of Title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing H.R.5445 To amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physicians services through December 31, 2009 H.R.5613 Protecting the Medicaid Safety Net Act of 2008 S.60 Wakefield Act S.243 Medical Care Access Protection (MCAP) Act of 2007 S.334 Healthy Americans Act S.558 Mental Health Parity Act of 2007 S.588 Resident Physician Shortage Reduction Act of 2007 S.793 Reauthorizations of the Traumatic Brain Injury Act S.999 Stroke Treatment & Ongoing Prevention Act S.1003 Access to Emergency Medical Services Act of 2007 S.1042 Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 S.1310 Medicare Ambulance Payment Extension Act S.1408 Health Information Technology Act of 2007 S.1519 Voluntary Medicare Quality Reporting Act S.1693 Wired for Health Care Quality Act S.1873 Improving Emergency Medical Care & Response Act of 2007 S.1947 Continuing the Advancement of Quality Improvement Act of 2007 S.1970 Kids in Disasters Well-Being, Safety & Health Act of 2007 S.2029 Physician Payments Sunshine Act of 2007 S.2319 National Trauma Center Stabilization Act of 2007 S.2406 Medicaid Emergency Psychiatric Care Act of 2007 S.2729 Ensuring the Future Physician Workforce Act of 2008 S.2785 Save Medicare Act of 2008 S.2819 Economic Recovery in Health Care Act of 2008

Client expense: $762,281 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1328, To amend the Indian Health Care Improvement Act to revise and extend that Act, sections as it relates to optometry and health care. HR 1983, To amend title XIX of the Social Security Act to require Medicaid coverage of professional services of optometrists that are otherwise covered when furnished by a physician, sections as it relates to optometry and health care. HR 6331, To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes, sections as it relates to optometry and health care. S 2785, Save Medicare Act of 2008, sections as it relates to optometry and health care. S 3101 , A bill to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes, sections as it relates to optometry and health care. S 3118, A bill to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes, sections as it relates to optometry and health care.

Client expense: $608,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

E-Prescribing, S. 2408/HR 4296 Medicare Electronic Medication and Safety Protection Act, Physician Disclosure, HR 5605/ S 2029 - Physician Payments Sunshine Act, Physician Reimbursement/Medicare Physician Fee Schedule, HR 3162, Children's Health and Medicare Protection Act, S. 2785, Save Medicare Act, HR 5545/S.2729 Ensuring the Future Physician Workforce, HR 5445 - to increase Medicare payments for physicians' services, Imaging, HR 1293/S1338, Access to Medicare Imaging Act, Health Information Technology S 1042/HR 583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act Appropriateness Criteria and Accreditation National Coverage Decision on CTA (CMS) National Coverage Decision on Percutaneous Transluminal Angioplasty concurrent w/Stenting (CMS) Quality Improvement (PQRI) Specialty Hospitals Comparative Effectiveness HR 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, the Medicare Improvements for Patients and Providers Act of 2008 S. 3118, Preserving Access to Medicare Act of 2008 Cardiac Magnetic Resonance Services Coverage for Carotid Stenting IDTF and Anti-markip rules in Physician Fee Schedule

Client expense: $750,000 · Firm income: Not reported

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

S. 2785, the Save Medicare Act, Medicare Physician Payment Reform. Physician Performance Measures S. 2250 and H.R. 1823, the Ambulatory Surgical Center Medicare Payment Modernization Act -- reform of payments and access to ambulatory surgical centers.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 3162 The Children's Health and Medicare Protection Act of 2007 - Section 505 "PPS Exempt Hospitals"; S 2785 The Save Medicare Act of 2008, Section 2 "Increase in Medicare Physician Payment Update"; Lobbying in support of adding a future cancer hospital affiliated with the Nevada Cancer Institute to the list of Medicare in-patient prospective payment system exempt cancer hospitals; Lobbying in support of preventing cuts in Medicare physician payments in 2008 and 2009

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3101, the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for physicians. H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008, Medicare reimbursement for physicians. S. 2785, Save Medicare Act of 2008, physician reimbursement issues. H.R. 5545 and S. 2729, Ensuring the Future Physician Workforce Act of 2008, physician reimbursement issues. H.R. 5445, to amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physician services through December 31, 2009, physician reimbursement issues. S. 2408 and H.R. 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007, issues related to electronic prescribing of medications. Private Fee for Service Plans in the Medicare Advantage Program, payment rates. Preservation of the whole-hospital exception to the Stark laws. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, concerning Medicaid regulations. Technical corrections for the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for physicians. Medicaid Tamper Resistant Pads. Medicare Program - Physician Quality Reporting Initiative Medicare Program - Medicare Electronic Health Record Demonstration project Medicare Program - Proposed Standards for E-prescribing under Medicare Part D. Medicare Program - Medicare Advantage Medicare Program - Physican Enrollment

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

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

HR 1647/S 399 - Amend Title XIX of the Social Security Act; S 2785, HR 5545, S 2729, HR 6091,S 3101, S 3118, HR 6331, HR 6119, HR 6252, S 3236, S 3144, HR 4105, HR 6331 - Issues related to Physician Reimbursement, Scarcity Area Bonuses, Physician Quality Reporting, DME and DME competitive bidding, RAC Moratorium; HR 6898 - Issues related to health information technology

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6331 (Medicare Improvements for Patients and Providers Act of 2008) to stabilize Medicare physician payments S 2785 (Save Medicare Act of 2008) to stabilize Medicare physician payments HR 2749 / S 1519 (Voluntary Medicare Quality Reporting Act of 2007) to evaluate the Physician Quality Reporting Initiative HR 1078 (Comprehensive Cancer Care Improvement Act of 2007) to expand cancer care planning, comprehensive symptom management and to authorize demonstrations for hospice and palliative care for cancer patients S 2029 (Physicians Payment Sunshine Act of 2007) to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP HR 583 / S 1042 (Consistency Accuracy Responsibility in Medical Imaging and Radiation Therapy Act of 2007) to establish standards for personnel who perform, plan, evaluate, or verify patient dose for medical imaging studies and radiation therapy treatments Encourage President Bush to consider an executive order to remove radiation therapy from the "in-office ancillary" services list of designated health services.

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

Government targets: HOUSE OF REPRESENTATIVES, Nuclear Regulatory Commission (NRC), SENATE

S.3: Medicare Prescription Drug Price Negotiation Act of 2007 S.158: Access to Affordable Health Care Act S. 273: Prescription Drug and Health Improvement Act of 2007 S. 290: Rural Physicians Relief Act of 2007 S. 334: Healthy Americans Act S. 397: Tax Equity and Affordability Act of 2007 S. 498: Rural Medicare Equity Act of 2007 S. 1342: HeLP America Act S. 1605: Craig Thomas Rural Hospital and Provider Equity Act of 2007 S. 1710: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 S. 2785: Save Medicare Act of 2008 S. 2603: Medicare Fraud Prevention Act of 2008 S. 2687: Medicare Beneficiary Protection Act of 2008 S. 2786: Medicare Rural Health Access Improvement Act of 2008 H.R.4: Medicare Prescription Drug Price Negotiation Act of 2007 H.R.15: National Health Insurance Act H.R.118: To amend part D of title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate prices for part D covered drugs for Medicare beneficiaries. H.R.205: Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.298: Flexible Spending Accounts Growth and Opportunities Act of 2007 HR 914: Tax Equity and Affordability Act of 2007 H.R. 1651: Rural Health Quality Advisory Commission Act of 2007 HR 2056: Medicare Part D Improvement Act of 2007 HR 2633: HeLP America Act (Introduced in House) HR 2860: Health Care Access and Rural Equity (H-CARE) Act of 2007 HR 3014: Health Equity and Accountability Act of 2007 H.R. 3043: Department of Health and Human Services Appropriations Act, 2008 HR 3163: Healthy Americans HR 4848: To extend for one year parity in the application of certain limits to mental health benefits, and for other purposes HR 1424: Paul Wellstone Mental Health and Addiction Equity Act of 2007 HR 5445: To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009. H.R. 6143: Pension Protection Act ERISA Amendments of 2008 H.R. 6382: Pension Protection Technical Corrections Act of 2008 H.R. 7242: Pension Protection Act IRC Amendments of 2008

Client expense: $2,095,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 5 for Medicare/Medicaid issues Specific Medicare/Medicaid bills: S. 3101/H.R. 6212/H.R. 6331, the Medicare Improvements for Patients and Providers Act (MIPPA) H.R. 6091/S. 2785, the Save Medicare Act H.R. 4935/H.R 4778/S. 3091, the Medicare Wound Therapy Patient Protection Act H.R. 2520/S. 1465 (relating to Medicare and medical mobility devices)

Client expense: Not reported · Firm income: Not reported

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

HR 748 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps S 450 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps HR 1552 - Medicare Patient Access to Physical Therapists Act S 932 - Medicare Patient Access to Physical Therapists Act HR 1846 - Medicare Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 HR 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S 2785 - Save Medicare Act of 2008 S 2460 - To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S 787 - To impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program HR 5590 - Medicare Oral Health Rehabilitative Enhancement Act of 2008 HR 5613 - Protecting Medicaid Safety Net Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H CON RES 312 - Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013 HR 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 1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 HR 3057 - Medicare Long-Term Care Patient Safety and Improvement Act of 2007 CORF, ORF conditions of participation- social and vocational services requirements Medicaid regulations promulgated by CMS Stark provisions in Fee Schedule Rule Physician Quality Reporting Initiative Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS) Regulations Medicare Post Acute Care Demo Medicare Home Health Demo Medicare Electronic Health Record demo CMS Alternative Payment System Project Comments to American Health Information Community re: successor Payment updates for physicians, hospitals, skilled nursing facilities, and home health Medicare Manual revisions In office ancillary services exception Inpatient Rehabilitation Facilities under Medicare Improving Funding for the Medicaid Program Extending legislative moratoria on Medicaid Regulations in President's FY 2009 budget Working with plan to mandate implementation of the International Classification of Diseases, 10th edition Medicaid Federal Medical Assistance Percentage (FMAP) 2009 Medicare Physician Fee Schedule Proposed Rule HR 6331-the Medicare Improvements for Patients and Providers Act S 3101- the Medicare Improvements for Patients and Providers Act S 3118 - Preserving Access to Medicare Act of 2008 HR 6252 - Medicare DMEPOS Competive Acquisition Reform Act of 2008 S 3144- Medicare DMEPOS Competive Acquisition Reform Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program S 2812 - Medicare Telehealth Improvement Act of 2008 HR 5445 - Increase Medicare Payments for physician services S 2785 - Increase Medicare Payments for physician services HR 5704 - Home Health Flexibility Act of 2008 Outpatient Hospital Medicaid Regulations

Client expense: $378,766 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

See page 5 for Medicare/Medicaid issues Specific Medicare/Medicaid bills: S. 3101/H.R. 6212/H.R. 6331, the Medicare Improvements for Patients and Providers Act (MIPPA) H.R. 6091/S. 2785, the Save Medicare Act H.R. 4935/H.R 4778/S. 3091, the Medicare Wound Therapy Patient Protection Act H.R. 2520/S. 1465 (relating to Medicare and medical mobility devices)

Client expense: $40,345 · Firm income: Not reported

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

S 2785/ HR 6091 -- Save Medicare Act of 2008

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

E-Prescribing, S. 2408/HR 4296 Medicare Electronic Medication and Safety Protection Act, Physician Disclosure, HR 5605/ S 2029 - Physician Payments Sunshine Act, Physician Reimbursement/Medicare Physician Fee Schedule, HR 3162, Children's Health and Medicare Protection Act, S. 2785, Save Medicare Act, HR 5545/S.2729 Ensuring the Future Physician Workforce, HR 5445 - to increase Medicare payments for physicians' services, Imaging, HR 1293/S1338, Access to Medicare Imaging Act, Health Information Technology S 1042/HR 583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act Appropriateness Criteria and Accreditation National Coverage Decision on CTA (CMS) National Coverage Decision on Percutaneous Transluminal Angioplasty concurrent w/Stenting (CMS) Quality Improvement (PQRI) Specialty Hospitals Comparative Effectiveness HR 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, the Medicare Improvements for Patients and Providers Act of 2008 S. 3118, Preserving Access to Medicare Act of 2008 Cardiac Magnetic Resonance Services Coverage for Carotid Stenting IDTF and Anti-markip rules in Physician Fee Schedule Value-based Purchasing

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

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

H.R. 1571, Seniors Access to Mental Health Act of 2007 (Medicare parity) H.R. 1663, Medicare Mental Health Modernization Act of 2007 H.R. 2626, Comprehensive HealthCARE Act of 2007 (Price Healthcare Bill) H.R. 3162, Children's Health and Medicare Protection Act of 2007 H.R. 2585, Ensuring the Future Physician Workforce Act of 2007 (Burgess SGR Bill) H.R. 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R. 3061, Medicare Part D Drug Class Protection Act of 2007 (Six Classes Bill) H.R. 820, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 1588, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007 (IMD-EMTALA) H.R. 882, Access to Emergency Medical Services Act of 2007 (EMTALA) S. 1887, Medicare Access to Critical Medications Act (Six Classes Bill) H.R. 470, to provide Medicare coverage of benzodiazepines and off-label uses of certain prescription drugs, optional Medicaid coverage of Medicare prescription drug cost-sharing, and authorization for the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage S. 137, Preserving Medicare for All Act of 2007 (Cardin Healthcare Bill, Includes Benzos) S. 588, Physician Shortage Act S. 1715, Medicare Mental Health Copayment Equity Act of 2007 S. 2499, Medicare, Medicaid, and SCHIP Extension Act S. 2785, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program H.R. 5445, Ensuring the Future Physician Workforce Act of 2007 (physician payment under Medicare) H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, Medicare Improvements for Patients and Providers Act of 2008 Conditions selected for coverage under the chronic conditions special needs plans (SNPs) HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS; Proposed Rule RIN 0958-AN25 [CMS-0013-P] 73 Federal Register 49796

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Institute of Mental Health (NIMH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA), White House Office

Reform of Medicare physician fee schedule and formula [Save Medicare Act (S. 2785) -- all provisions] Issues pertaining to medical home

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1404-P: Medicare Program: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates (Provisions affecting ASC payments) CMS-1392-FC: Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) CMS-1403-P: Proposed Revision 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) (Provisions relating to anti-mark-up rule, independent diagnostic testing facilities, pay-for-performance/reporting, physician update and Welcome-to-Medicare physical) CMS0013P: HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD10CM and ICD10PCS (Proposed rule) CMS0009P: Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (Proposed rule; timeframe for adoption of 5010 standard) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101/H.R. 6331/P.L. 110-275, "Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy HR 6357: Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008' or the `PRO(TECH)T Act of 2008'. S. 3343/H.R. 6821 The Medicare Imaging Disclosure Sunshine Act of 2008 H. Res. 1381, Expressing the sense of the House that there should be an increased Federal commitment prioritizing prevention and public health for all people in the United States S. 3584, Obesity Prevention, Treatment, and Research Act of 2008 Revisions to the National Cancer Act, focus on lethal cancers

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1404-P: Medicare Program: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates (Provisions affecting ASC payments) CMS-1392-FC: Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) CMS-1403-P: Proposed Revision 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) (Provisions relating to anti-mark-up rule, independent diagnostic testing facilities, pay-for-performance/reporting, physician update and Welcome-to-Medicare physical) CMS0013P: HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD10CM and ICD10PCS (Proposed rule) CMS0009P: Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (Proposed rule; timeframe for adoption of 5010 standard) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101/H.R. 6331/P.L. 110-275, "Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy HR 6357: Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008' or the `PRO(TECH)T Act of 2008'. S. 3343/H.R. 6821 The Medicare Imaging Disclosure Sunshine Act of 2008 H. Res. 1381, Expressing the sense of the House that there should be an increased Federal commitment prioritizing prevention and public health for all people in the United States S. 3584, Obesity Prevention, Treatment, and Research Act of 2008 Revisions to the National Cancer Act, focus on lethal cancers

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. Supplemental Appropriations Act, 2008 (HR 2642) Sec. 7001. (a) Moratoria on Certain Medicaid Regulations HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program HR 7110: Job Creation and Unemployment Relief Act: Title III, temporary increase in Medicaid matching rate S 3656: Preserving Access to Healthcare (PATH) Act -- which would delay cuts to Medicare capital indirect medical education (IME) payments for six months provisions in the developing economic stimulus package to temporarily increase FMAP self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce: HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program the Fiscal Year (FY) 2009 inpatient prospective payment system (IPPS) final rule eliminated indirect medical education (IME) adjustments to teaching hospitals' capital payments proposed rule to implement National Defense Authorization Act for Fiscal Year 2002" requirement that TRICARE payment methods for outpatient hospital care be determined outpatient reimbursement rules used by Medicare S 3656: to delay cuts to Medicare capital indirect medical education (IME) payments for six months quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, White House Office

Medical and health care policy matters associated with post-Katrina disaster area adjustments for Medicare graduate medical education programs and hospital wage index mechanisms; and, health care redesign and reform initiatives in New Orleans and/or Louisiana area. Also supported the general stabilization of Medicare payments to physicians and hospitals. H.R. 5613 - Protecting the Medicaid Safety Net Act of 2008 S. 2460 - (Medicaid bill -Unnamed) To extend by one year the moratorium on implementation of a rule related to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S. 2819 - Economic Recovery in Health Care Act of 2008 H.R. 3533- The Public and Teaching Hospital Preservation Act - Supported extension of moratorium of Medicaid rules affecting the use of Medicaid funds to support programs of graduate medical education. S.2785- Save Medicare Act of 2008 - Supported the stabilization of Medicare payments to physicians and hospitals. H.R. 2642- Supplemental Appropriations Act, 2008 -Supported post-Katrina financial relief for New Orleans area hospitals, and extension of a moratorium on Medicaid rules affecting the use of Medicaid funds to support programs of graduate medical education. S.3101- The Medicare Improvement for Patients and Providers Act of 2008-Supported the stabilization of Medicare payments to physicians and hospitals. H.R. 6331- Medicare Improvements for Patients and Providers Act of 2008-Supported the stabilization of Medicare payments to physicians and hospitals. S. 3656- Preserving Access to Healthcare Act of 2008 - Supported the preservation of capital indirect medical education payments for teaching hospitals. Health care information technology and Medicare capital indirect medical education payments to teaching hospitals that may be part of the emerging 2009 economic stimulus legislation.

Client expense: $160,000 · 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), Office of Management & Budget (OMB), SENATE, White House Office

H.R.2050 - Medicaid Emergency Psychiatric Care Act of 2007 H.R. 2164 - Medicare Ambulance Payment Extension Act H.R.2749 - Voluntary Medicare Quality Reporting Act H.R.4736 - To Amend Part B of title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing H.R.5613 - Protecting the Medicaid Safety Net Act of 2008 H.R.6091 - Save Medicare Act of 2008 S.1310 - Medicare Ambulance Payment Extension Act S.1519 - Voluntary Medicare Quality Reporting Act S.2406 - Medicaid Emergency Psychiatric Care Act of 2007 S.2785 - Save Medicare Act of 2008

Client expense: $482,302 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2007 H.R.882 - Access to Emergency Medical Services Act of 2007 H.R.1108 - Family Smoking Prevention and Tobacco Control Act H.R.1233 - Mitigating the Impact of Uncompensated Service and Time Act of 2007 H.R.2050 - Medicaid Emergency Psychiatric Care Act of 2007 H.R. 2164 - Medicare Ambulance Payment Extension Act H.R.2464 - Wakefield Act H.R.2583 - Physician Workforce and Graduate Medical Education Enhancement Act of 2007 H.R.2584 - High-Need Physician Workforce Incentives Act of 2007 H.R.2749 - Voluntary Medicare Quality Reporting Act H.R.3163 - Healthy Americans Act H.R.3344 - Treat Physicians Fairly Act of 2007 H.R.3495 - Kids in Disasters Well-Being, Safety and Health Act of 2007 H.R.3800 - Promoting Health Information Technology Act H.R.4321 - Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2007 H.R.4736 - To Amend Part B of title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing H.R.5545 - Ensuring the Future Physician Workforce Act of 2008 H.R.5605 - Physician Payments Sunshine Act of 2008 H.R.5613 - Protecting the Medicaid Safety Net Act of 2008 H.R.5942 - National Trauma Center Stabilization Act of 2008 H.R.6091 - Save Medicare Act of 2008 H.R.6357 - Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 H.R.6898 - Health-e Information Technology Act of 2008 P.L.110-343 - Emergency Economic Stabilization Act of 2008 (Specifically - Subtitle B: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 P.L.110-355 - Health Care Safety Net Act of 2008 P.L.110-377 - Poison Center Support, Enhancement and Awareness Act of 2008 P.L. 110-379 - QI Program Supplemental Funding Act of 2008 P.L.110-381 - Michelle's Law S.60 Wakefield Act S.334 Healthy Americans Act S.625 - Family Smoking Prevention and Tobacco Control Act S.1003 - Access to Emergency Medical Services Act of 2007 S.1042 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2007 S.1310 - Medicare Ambulance Payment Extension Act S.1519 - Voluntary Medicare Quality Reporting Act S.1693 - Wired for Health Care Quality Act S.1970 Kids in Disasters Well-Being, Safety and Health Act of 2007 S.2029 - Physician Payments Sunshine Act of 2007 S. 2319 - National Trauma Center Stabilization Act of 2007 S.2406 - Medicaid Emergency Psychiatric Care Act of 2007 S.2729 - Ensuring the Future Physician Workforce Act of 2008 S.2785 - Save Medicare Act of 2008 S.2819 - Economic Recovery in Health Care Act of 2008

Client expense: $482,302 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

To improve Medicare, Medicaid equity. S.456,S773,S.1075,S.2785,S.2799,S.3101 HR748,HR1108,HR2319,HR3038,HR4107,HR5465,HR6185,HR6331,HR6600,HR6832

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)

H.R. 3282, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007 S. 2785, Save Medicare Act of 2008 H.R. 6331, Medicare Improvement for Patients and Providers Act of 2008

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

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

S. 3230, Labor-HHS-Education Appropriations Bill, FY 2009, appropriations for National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Allergy and Infectious Diseases, and National Institute of Child Health and Human Development S. 2785, Save Medicare Act of 2008

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

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

H.R. 3162, Children's Health and Medicare Protection Act of 2007 S. 1693, Wired for Health Care Quality Act H.R. 2991, Independent Health Record Trust Act S. 691/H.R. 1193, Kidney Care Quality and Education Act of 2007 S. 2785, Save Medicare Act of 2008 H.R. 6331, Medicare Improvement for Patients and Providers Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2053, Medicare Anesthesiology Teaching Funding Restoration Act of 2007 S. 2056, Medicare Anesthesiology Teaching Funding Restoration Act of 2007 H.R. 1866, Medicare Access to Rural Anesthesiology Act of 2007 H.R. 5545, To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S. 2729, A bill to amend title XVIII of the Social Security Act to modify Medicare physician reimbursement policies to ensure a future physician workforce, and for other purposes S. 2785, A bill to amend title XVIII of the Social Security Act to preserve access to physicians' services under the Medicare program S. 3118, Preserving Access to Medicare Act of 2008 S. 3101, Medicare Improvements for Patients and Providers Act of 2008 H.R. 1932, Medicare Academic Anesthesiology and CRNA Payment Improvement Act of 2007 H.R. 4105, To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program H.R. 6331, Medicare Improvement for Patients and Providers Act of 2008 H.R. 6898, Health-e Information Technology Act of 2008 Part B Medicare Physician's Fee Schedule Physician Quality Reporting Initiative/QIOs Scope of Practice CMS ACE Demonstration CMS Interpretative Guidelines CMS IPPS Medicare Payment CMS Physician Resource Use Reports CMS ICD-10 CMS Hospital Outpatient Payment Proposed Rule Medicare Reform- Perioperative Care CMS Coverage Decision re: Never Events CMS Physician Based Value Reporting CMS 5010 Comment Letter CMS Hospital Acquired Conditions

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

Government targets: 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), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. HR 5445- To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009, all provisions. CMS Transmittals- 84, 1470, and 1550 - "Incident to" policy relating to audiology services.

Client expense: $98,648 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Personnel Management (OPM), SENATE

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; Include expansion of the medical home as well as transformation grants for the medical home in SCHIP re-authorizing legislation Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Client expense: $269,132 · Firm income: Not reported

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

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; Include expansion of the medical home as well as transformation grants for the medical home in SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Client expense: $142,652 · Firm income: Not reported

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

CMS reimbursement policy for Medicare physician services. H.R. 2585 - Ensuring the Future Physician Workforce Act of 2007 S. 2729 - Ensuring the Future Physician Workforce Act of 2008 H.R. 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S. 2785 - Save Medicare Act of 2008 - To amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program. H.R. 6331 - Medicare Improvements for Patients and Providers Act. S. 3101 - Medicare Improvements for Patients and Providers Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6331, the Medicare Improvements for Patients and Providers Act; S.2785, the Save Medicare Act and issues affecting physicians and ancilliary reimbursement and other health care policy issues; S.2065, H.R. 3561 The Community Coalition for Access and Quality Improvement Act, related to Communicty Access Funding; H.R. 4105 regarding placing a one-year moratorium on the Medicare Recovery Audit Program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 5 for Medicare/Medicaid issues Specific Medicare/Medicaid bills: H.R. 6331, the Medicare Improvements for Patients and Providers Act (MIPPA) H.R. 6091/S. 2785, the Save Medicare Act S. 3101/H.R. 6212/H.R. 6331, the Medicare Improvements for Patients and Providers Act H.R. 4935/H.R. 4778/S. 3091, the Medicare Wound Therapy Patient Protection Act H.R. 2520/S.1465 (relating to Medicare and medical mobility devices) H. Res. 1368, Medicare Funding Trigger

Client expense: $61,364 · Firm income: Not reported

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

Sustainable Growth Rate- Support legislation that would halt Medicare physician payment cuts and support a permanent replacement for the current sustainable growth rate (SGR) that reflects current medical costs. (H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, H.R. 2626, the Comprehensive HealthCARE act of 2007, S.2785, the Save Medicare Act of 2008); Technical Component Grandfather Support legislation that provides a permanent grandfather provision allowing independent laboratories to bill Medicare directly for certain physician pathology services. (H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, H.R. 1105 and S. 458 the Physician Pathology Services Continuity Act of 2007) Competitive Bidding Demonstration Project- Support legislation that would repeal the Medicare Laboratory Competitive Bidding Demonstration project for diagnostic laboratory services. (H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, H.R. 3453, the Community Clinical Laboratory Fairness in Competition Act of 2007, S 2099, the Preserving Access to Laboratory Services Act of 2007) Relative Value Update Reform- Oppose efforts to replace the current relative value review process with a federal advisory committee. Pay for Performance/Physician Quality Reporting Initiative (PQRI)- Ensure pathologists continue to have the option to participate in PQRI program and monitor for any potential harm. Support legislation that establishes and continues a bonus payment program under the PQRI. (H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008)

Client expense: $323,257 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE

Reform of Medicare physician fee schedule and formula [Save Medicare Act (S. 2785) -- all provisions; Medicare Improvements for Patients and Providers Act (H.R. 6331, S. 3101) -- all provisions] Issues pertaining to medical home [Medicare Improvements for Patients and Providers Act (H.R. 6331) -- Section 133]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. HR 5445- To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009, all provisions. CMS Transmittals- 84, 1470, and 1550 - "Incident to" policy relating to audiology services.

Client expense: $90,262 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Personnel Management (OPM), SENATE

S. 3101, the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for physicians. H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008, Medicare reimbursement for physicians. S. 2785, Save Medicare Act of 2008, physician reimbursement issues. H.R. 5545 and S. 2729, Ensuring the Future Physician Workforce Act of 2008, physician reimbursement issues. H.R. 5445, to amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physician services through December 31, 2009, physician reimbursement issues. S. 2408 and H.R. 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007, issues related to electronic prescribing of medications. Private Fee for Service Plans in the Medicare Advantage Program, payment rates. Preservation of the whole-hospital exception to the Stark laws. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, concerning Medicaid regulations. Medicaid Tamper Resistant Pads. Medicare Program - Physician Quality Reporting Initiative Medicare Program - Medicare Electronic Health Record Demonstration project Medicare Program - Proposed Standards for E-prescribing under Medicare Part D. Medicare Program - Medicare Advantage Medicare Program - Physican Enrollment

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

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

See page 5 for Medicare/Medicaid issues. Specific Medicare/Medicaid bills: H.R. 6331, the Medicare Improvements for Patients and Providers Act (MIPPA) H.R. 6091/S. 2785, the Save Medicare Act S. 3101/H.R. 6212/H.R. 6331, the Medicare Improvements for Patients and Providers Act H.R. 4935/H.R. 4778/S. 3091, the Medicare Wound Therapy Patient Protection Act H.R. 2520/S.1465 (relating to Medicare and medical mobility devices) H. Res. 1368, Medicare Funding Trigger

Client expense: Not reported · Firm income: Not reported

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

See page 5 for Medicare/Medicaid issues Specific Medicare/Medicaid bills: H.R. 6331, the Medicare Improvements for Patients and Providers Act (MIPPA) H.R. 6091/S. 2785, the Save Medicare Act S. 3101/H.R. 6212/H.R. 6331, the Medicare Improvements for Patients and Providers Act H.R. 4935/H.R. 4778/S. 3091, the Medicare Wound Therapy Patient Protection Act H.R. 2520/S.1465 (relating to Medicare and medical mobility devices) H. Res. 1368, Medicare Funding Trigger

Client expense: $97,022 · Firm income: Not reported

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

HR 748 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps S 450 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps HR 1552 - Medicare Patient Access to Physical Therapists Act S 932 - Medicare Patient Access to Physical Therapists Act HR 1846 - Medicare Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 HR 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S 2785 - Save Medicare Act of 2008 S 2460 - To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S 787 - To impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program HR 5590 - Medicare Oral Health Rehabilitative Enhancement Act of 2008 HR 5613 - Protecting Medicaid Safety Net Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H CON RES 312 - Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013 HR 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 1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 HR 3057 - Medicare Long-Term Care Patient Safety and Improvement Act of 2007 CORF, ORF conditions of participation- social and vocational services requirements Medicaid regulations promulgated by CMS Stark provisions in Fee Schedule Rule Physician Quality Reporting Initiative Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS) Regulations Medicare Post Acute Care Demo Medicare Home Health Demo Medicare Electronic Health Record demo CMS Alternative Payment System Project Comments to American Health Information Community re: successor Payment updates for physicians, hospitals, skilled nursing facilities, and home health Medicare Manual revisions In office ancillary services exception Inpatient Rehabilitation Facilities under Medicare Improving Funding for the Medicaid Program Extending legislative moratoria on Medicaid Regulations in President's FY 2009 budget Working with plan to mandate implementation of the International Classification of Diseases, 10th edition Medicaid Federal Medical Assistance Percentage (FMAP) 2009 Medicare Physician Fee Schedule Proposed Rule HR 6331-the Medicare Improvements for Patients and Providers Act S 3101- the Medicare Improvements for Patients and Providers Act S 3118 - Preserving Access to Medicare Act of 2008 HR 6252 - Medicare DMEPOS Competive Acquisition Reform Act of 2008 S 3144- Medicare DMEPOS Competive Acquisition Reform Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program S 2812 - Medicare Telehealth Improvement Act of 2008 HR 5445 - Increase Medicare Payments for physician services S 2785 - Increase Medicare Payments for physician services HR 5704 - Home Health Flexibility Act of 2008 Outpatient Hospital Medicaid Regulations

Client expense: $355,739 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Medicare Physician Payment Medicare Reimbursement Hospital Outpatient APCs Save Medicare Act of 2008 (S. 2785) Medicare Improvements for Patients and Providers Act (H.R. 6331/S. 3101) Potential National Coverage Decision Topics Proposed Rule on the Electronic Prescriptions for Controlled Substances

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Nuclear Regulatory Commission (NRC), SENATE

H.R. 1571, Seniors Access to Mental Health Act of 2007 (Medicare parity) H.R. 1663, Medicare Mental Health Modernization Act of 2007 H.R. 2626, Comprehensive HealthCARE Act of 2007 (Price Healthcare Bill) H.R. 3162, Children's Health and Medicare Protection Act of 2007 H.R. 2585, Ensuring the Future Physician Workforce Act of 2007 (Burgess SGR Bill) H.R. 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R. 3061, Medicare Part D Drug Class Protection Act of 2007 (Six Classes Bill) H.R. 820, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 1588, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007 (IMD-EMTALA) H.R. 882, Access to Emergency Medical Services Act of 2007 (EMTALA) S. 1887, Medicare Access to Critical Medications Act (Six Classes Bill) H.R. 470, to provide Medicare coverage of benzodiazepines and off-label uses of certain prescription drugs, optional Medicaid coverage of Medicare prescription drug cost-sharing, and authorization for the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage S. 137, Preserving Medicare for All Act of 2007 (Cardin Healthcare Bill, Includes Benzos) S. 588, Physician Shortage Act S. 1715, Medicare Mental Health Copayment Equity Act of 2007 S. 2499, Medicare, Medicaid, and SCHIP Extension Act S. 2785, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program H.R. 5445, Ensuring the Future Physician Workforce Act of 2007 (physician payment under Medicare) H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, Medicare Improvements for Patients and Providers Act of 2008 Notice of Proposed Rulemaking: 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 Notice of Proposed Rulemaking: Proposed Changes to the Hospital Outpatient Prospective, Ambulatory Surgical Center Payment Systems and CY 2009 Payment Rates

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

Government targets: Bureau of Prisons (BOP), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Aviation Administration (FAA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Institute of Mental Health (NIMH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

S 2785 -- Save Medicare Act of 2008 (regarding graduate medical education; intergovernmental transfers)

Client expense: $140,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Aeronautics & Space Administration (NASA), Natl Endowment for the Humanities, Natl Institutes of Health (NIH), Natl Oceanic & Atmospheric Administration (NOAA), Natl Science Foundation (NSF), SENATE, U.S. Geological Survey (USGS), Veterans Affairs, Dept of (VA)

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. Supplemental Appropriations Act, 2008 (HR 2642) Sec. 7001. (a) Moratoria on Certain Medicaid Regulations HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program HR 7110: Job Creation and Unemployment Relief Act: Title III, temporary increase in Medicaid matching rate S 3656: Preserving Access to Healthcare (PATH) Act -- which would delay cuts to Medicare capital indirect medical education (IME) payments for six months self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, White House Office

H.R.583 - Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 H.R.882 - Access to Emergency Medical Services Act of 2007 H.R.1108 - Family Smoking Prevention and Tobacco Control Act H.R.1233 - Mitigating the Impact of Uncompensated Services & Time Act of 2007 H.R.1343 - Health Centers Renewal Act of 2008 H.R.1424 - Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1553 - Caroline Pryce Walker Conquer Childhood Cancer Act of 2008 H.R.2164 - Medicare Ambulance Payment Extension Act H.R.2464 - Wakefield Act H.R.2583 - Physician Workforce & Guidance Medical Education Enhancement Act of 2007 H.R.2584 - High-Need Physician Workforce Incentives Act of 2007 H.R.2638 - Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 H.R.2749 - Voluntary Medicare Quality Reporting Act H.R.2851 - Michelle's Law H.R.3163 - Healthy Americans Act H.R.3173 - Improving Emergency Medical Care & Response Act of 2007 H.R.3344 - Treat Physicians Fairly Act of 2007 H.R.3403 - 911 Modernization and Public Safety Act H.R.3495 - Kids in Disasters Well-Being, Safety & Health Act of 2007 H.R.3800 - Promoting Health Information Technology (PHIT) Act H.R.4321 - Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2007 H.R.4736 - To Amend Part B of Title XVIII of the Social Security Act to Repeal Limiting Charges Under the Medicare Program for Non-Participating Physicians and to Preempt State Laws that Prohibit Balance Billing H.R.5545 - Ensuring the Future Physician Workforce Act of 2008 H.R.5605 - Physician Payments Sunshine Act of 2008 H.R.5613 - Protecting the Medicaid Safety Net Act of 2008 H.R.5669 - Poison Center Support, Enhancement & Awareness Act of 2008 H.R.5942 - National Trauma Center Stabilization Act of 2008 H.R.6091 - Save Medicare Act of 2008 H.R.6331 - Medicare Improvements for Patients & Providers Act (MIPPA) of 2008 H.R.6357 - Protecting Records, Optimizing Treatment, and Easing Communication Through Healthcare Technology Act of 2008 H.R.6898 - Health-e Information Technology Act of 2008 P.L.110-252 - Supplemental Appropriations Act of 2008 S.60 - Wakefield Act S.334 - Healthy Americans Act S.558 - Mental Health Parity Act of 2007 S.625 - Family Smoking Prevention and Tobacco Control Act S.901 - Health Care Safety net Act of 2007 S.911 - Conquer Childhood Cancer Act of 2007 S.1003 - Access to Emergency Medical Services Act of 2007 S.1042 - Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 S.1310 - Medicare Ambulance Payment Extension Act S.1519 - Voluntary Medicare Quality Reporting Act S.1693 - Wired for Health Care Quality Act S.1873 - Improving Emergency Medical Care & Response Act of 2007 S.1970 - Kids in Disasters Well-Being, Safety & Health Act of 2007 S.2029 - Physician Payments Sunshine Act of 2007 S.2319 - National Trauma Center Stabilization Act of 2007 S.2406 - Medicaid Emergency Psychiatric Care Act of 2007 S.2729 - Ensuring the Future Physician Workforce Act of 2008 S.2785 - Save Medicare Act of 2008 S.2819 - Economic Recovery in Health Care Act of 2008 S.2932 - Poison Center Support, Enhancement & Awareness Act of 2008 S.3101 - Medicare Improvements for Patients & Providers Act (MIPPA) of 2008 S.3560 - QI Program Supplemental Funding Act of 2008

Client expense: $528,537 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE