Small Business Health Options Program Act of 2008

Supported health care reform legislation, including changes to HR 3200 (America's Affordable Health Choices Act) that will provide access to affordable insurance without imposing costly employer mandates. Supported legislative initiatives to allow small companies to pool together collectively across state lines and purchase economical health plans, such as S 2795 and HR 6210, the Small Business Health Options Program (SHOP) Act, introduced during the 110th Congress.

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

Government targets: Bureau of Land Management (BLM), Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Natl Highway Traffic Safety Administration (NHTSA), SENATE, U.S. Forest Service

Supported health care reform legislation that will provide access to affordable insurance without imposing costly employer mandates. Supported legislative initiatives to allow small companies to pool together collectively across state lines and purchase economical health plans, such as S 2795 and HR 6210, the Small Business Health Options Program (SHOP) Act, introduced during the 110th Congress.

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

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), SENATE, U.S. Forest Service

Undertook lobbying activity in suport of small business health care reform to allow small companies to pool together collectively across state lines and purchase economical health plans, such as S 2795 and HR 6210, the Small Business Health Options Program (SHOP) Act, introduced during the 110th Congress.

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

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), SENATE, U.S. Forest Service

Health Insurance (House) S 2795, S334 See original report filed in 2008

Client expense: $7,220,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Mental Health Parity, S. 558, Benefit Mandates Association Health Plans/Small Business Health Plans Tax Credits, Health Savings Accounts, Flexible Spending Accounts HSA Improvement/Expansion Act- H.R. 3234 National Health Information Incentive Act- H.R. 1952 Uniform application of ERISA mandates Workforce Training SHOP Act- S. 2795, H.R. 6210 CHOICE Act- H.R. 6582 Health Care Reform

Client expense: $1,120,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Treasury, Dept of, White House Office

Healthy Families Act, H.R. 1542 Baucus Health Care Proposal Healthy Families Act, S. 910 Emergency Nursing Supply Relief Act, H.R. 5924 James Zadroga 9/11 Health and Compensation Act of 2008, H.R. 7174 Small Business Health Options Program Act, S. 2795 Wellstone Mental Health and Addiction Equity Act of 2007, H.R. 1424 Discussions re health care agencies-- CMS, AHRW, HHS

Client expense: $260,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.Con.Res. 312 - Budget resolution FY2009 Bill establishes the congressional budget for the Federal Government for fiscal year 2009, and sets forth appropriate budgetary levels for fiscal years 2010 through 2013. NSBA supported certain sections and amendments of the resolution. H.R. 25 - Fair Tax Act or 2007 Legislation to abolish the Internal Revenue Service and enacting a national sales tax. NSBA supported. H. R. 731 - National Small Business Regulatory Assistance Act of 2007 Bill would require the SBA to establish a program providing regulatory-compliance assistance to small businesses. NSBA supported. H.R. 1023 - Withholding Tax Relief Act of 2007 A bill to repeal a provision designed to increase federal tax revenue by $7 billion over ten years. Repeal the new mandatory 3 percent withholding requirement on all payments for goods and services made to federal, state and local contractors. NSBA supports. H.R. 1112 - Stealth Tax Relief Extension Act of 2007 The legislation increases the exemption from the alternative minimum tax for individual taxpayers in 2007 and extends through 2007 the allowance of certain nonrefundable tax credits against alternative minimum tax liability. NSBA supported. H.R. 1332 Small Business Lending Improvements Act of 2007 Bill would improve the access to capital programs of the SBA. NSBA supported. H.R. 1424 - Emergency Economic Stabilization Act of 2008 Bill addressed the expiration of popular tax provisions such as the AMT patch, research and development tax credits and various other credits and deductions designed to encourage renewable energies. NSBA supported. H.R. 1506 Fuel Economy Reform Act Measure would increase fuel economy standards for automobiles. NSBA supported. H.R. 1542 Healthy Families Act Bill to expand the Family Medical Leave Act (FMLA) to require that employers with 15 or more employees provide up to 7 paid sick-leave days to their employees. NSBA opposed. H.R. 1677 Taxpayer Protection Act of 2007 Bill gives IRS the right to deny information to tax preparers and lenders who might be contemplating predatory refund anticipation loans (RALs). It also includes provisions on the earned income tax credit and individual retirement accounts. NSBA supported. H.R. 1873 Small Business Fairness in Contracting Act of 2007 Bill would improve federal procurement opportunities for small businesses. NSBA supported. H.R. 2205/S. 1010 Retirement Security for Life Act To amend the Internal Revenue Code of 1986 to encourage guaranteed lifetime income payments from annuities and similar payments of life insurance proceeds at dates later than death by excluding from income a portion of such payments. NSBA supports retirement options for its employees, but NSBA has remained largely neutral on this proposal. H.R. 2380 - Death Tax Repeal Permanency Act of 2007 To make permanent the repeal of the estate tax after 2010. NSBA supported H.R. 2419 - Farm, Nutrition, and Bioenergy Act of 2007 Bill includes tax incentives for farms, energy and conservation initiatives. NSBA opposed certain revenue-offsets in the bill. H.R. 2727 Small Business SOX Compliance Extension Act It would extend the current exemption by at least one year for small businesses to comply with the Sarbanes-Oxley internal controls reporting requirements. NSBA supported. H.R. 3163 - The Healthy Americans Act Broad health care reform that includes an individual mandate, creation of state Health Help Agencies, subsidies for low-income individuals and changes tax-treatment of health care and health insurance expenditures. NSBA supported sections of the bill. H.R. 3170 Capital Gains and Estate Tax Relief Act of 2007 The bill permanently reduces the capital gains tax to 15 percent and the estate tax exemption will be $3.5 million in 2009 and will increase $250,000 per year until it reaches $5 million 2015. NSBA supported. H.R. 3221 - New Direction for Energy Independence, National Security, and Consumer Protection Act The bill provides economic aid to the housing industry and amend the Internal Revenue Code of 1986 to provide tax incentives for the production of renewable energy and energy conservation. NSBA opposed certain revenue-offsets in the bill. H.R. 3548 - Plain Language in Government Communications Act of 2007 Bill would establish plain language as the standard style for Government documents issued to the public, and for other purposes. NSBA supported. H.R. 3567 - the Small Business Investment Expansion Act of 2007 Bill would expand the ability of venture capital-owned businesses to participate in small-business programs. NSBA opposed. H.R. 3660 - Equity for Our Nations Self-Employed Act of 2007 Would allow self-employed individuals to fully-deduct the cost of their health insurance, thus eliminating the self-employed tax on health care. NSBA supported. H.R. 4008 - Credit and Debit Card Receipt Clarification Act of 2007 Bill provides technical corrections to the definition of willful noncompliance in regard to unintentional violations of the Fair Credit Reporting Act. NSBA supported. H.R. 4458 - the Small Business Regulatory Improvement Act Bill seeks to improve the Regulatory Flexibility Act and reduce the regulatory burden borne by Americas small businesses. NSBA supported. H.R. 5140 - Economic Stimulus Act of 2008 Bill provides economic stimulus through recovery rebates to individuals, incentives for business investment, and an increase in conforming and FHA loan limits. NSBA supported. H.R. 5244 - The Credit Cardholders Bill of Rights Bill would prohibit or reform various credit-card practices. NSBA supported. H.R. 5351 - Renewable Energy and Energy Conservation Tax Act Bill would extend a range of renewable energy tax incentives NSBA supported. H.R. 5402 - Climate Change Center and Clearinghouse Act of 2007 Bill would charge the SBA and EPA to co-chair an interagency working group across federal agencies and establish a clearinghouse of climate-change related information for small businesses. NSBA supported. H.R. 5719 - Taxpayer Assistance and Simplification Act of 2008 Bill amends the Internal Revenue Code of 1986 to conform return preparer penalty standards, delay implementation of withholding taxes on government contractors, enhance taxpayer protections, and assist low-income taxpayers. NSBA supported certain provisions of the measure. H.R. 5819 SBIR STTR Reauthorization Act Bill would reauthorize the Small Business Innovation Research (SBIR) program. NSBA supported. H.R. 6049 - Renewable Energy and Job Creation Act of 2008 Bill amends the Internal Revenue Code of 1986 to provide incentives for energy production and conservation, extend certain expiring tax provisions, and provide individual income tax relief. NSBA supported. H.R. 6210 Small Business Health Options Program Act of 2008 Amends the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make coverage more affordable, predictable, and accessible. NSBA supported certain sections of the bill. H.R. 6214 Home Office Deduction Standardization Act of 2008 It amends the Internal Revenue Code to allow a taxpayer who uses a residence to conduct a trade or business a standard tax deduction equal to the lesser of $1,500 or the taxpayer's gross trade or business income derived from the business use of such residence. NSBA supported. H.R. 6275 - Alternative Minimum Tax Relief Act of 2008 Bill provides individuals temporary relief from the alternative minimum tax. NSBA supported bill, but opposed offsets. H.R. 6499 Sensible Tax Act of 2008 Beginning in 2009, the legislation would permanently exclude the first $2 million ($4 million for a couple) of an estates value from being subject to any tax and subsequently be adjusted for inflation. The measure would ensure that the surviving spouse is entitled to the $2 million to which the deceased spouse was entitled. NSBA supported. H.R. 6582 - Small Business CHOICE Act of 2008 To encourage the development of small business cooperatives for healthcare options to improve coverage for employees (CHOICE) including through a small business CHOICE tax credit. NSBA supports elements of this legislation to the extent it addresses rising health care cost and insurance availability for small business owners. However, NSBA maintains reservations about the use of cooperatives to achieve this. H.R. 6601 Small Business Tax Modernization Act of 2008 Bill creates a standard home office deduction, removes cell phones from listed property, allows nonresident aliens to be S corporation shareholders, increases the deduction for business meals and entertainment for qualified small businesses, and reduces the recovery period for depreciation of heating, ventilation, air conditioning, and refrigeration (HVACR) equipment. NSBA supported. H.R. 6633 - Employee Verification Amendment Act of 2008 To evaluate and extend the basic pilot program for employment eligibility confirmation and to ensure the protection of Social Security beneficiaries. NSBA supports the employment of legal employees, but remains cautious of mandating a system such as E-verify on small businesses owners due to burdensome administrative task, unwarranted penalties and historical technical errors with the E-verify system. H.R. 6983 - Paul Wellstone Mental Health and Addiction Equity Act of 2008 Would require health plans that offer mental health benefits to cover the same mental health and addiction disorders that are included in the Federal Employee Health Benefits Program (FEHBP). NSBA opposed. H.R. 7060 - Renewable Energy and Job Creation Tax Act of 2008 Bill includes an extension of individual and business tax provisions and energy tax incentives. NSBA supported. H.R. 7074 Home Office Tax Deduction Simplification Act Bill brings clarity to the process of claiming the tax deduction for a home office and directs the Secretary of Treasury to establish an optional standard deduction. NSBA supported. S.Con.Res. 70 - Bill establishes the congressional budget for the Federal Government for fiscal year 2009, and sets forth appropriate budgetary levels for fiscal years 2010 through 2013. NSBA supported certain sections and amendments of the resolution. S. 55 - Individual Alternative Minimum Tax Repeal Act of 2007 The measure repeals the alternative minimum tax on individuals. NSBA supported. S. 102 A bill to extend and expand relief from the alternative minimum tax and to repeal the extension of the lower rates for capital gains and dividends for 2009 and 2010. The legislation increases the exemption from the alternative minimum tax for individual taxpayers in 2007 and extends through 2007 the allowance of certain nonrefundable tax credits against alternative minimum tax liability. NSBA supported. S. 334 The Healthy Americans Act Broad health care reform that includes an individual mandate, creation of state Health Help Agencies, subsidies for low-income individuals and changes tax-treatment of health care and health insurance expenditures. NSBA supported sections of the bill S.558 Mental Health Parity Act of 2007 Legislation would require insurance companies to offer the same level of financial coverage for mental health care as they do for other medical care. NSBA opposed S. 777 Withholding Tax Relief Act of 2007 A bill to repeal a provision designed to increase federal tax revenue by $7 billion over ten years. Repeal the new mandatory 3 percent withholding requirement on all payments for goods and services made to federal, state and local contractors. NSBA supports. S. 910 Healthy Families Act Bill to expand the Family Medical Leave Act (FMLA) to require that employers with 15 or more employees provide up to 7 paid sick-leave days to their employees. NSBA opposed S. 1145 - The Patent Reform Act of 2007 Bill would provide comprehensive reform the U.S. patent system. NSBA opposed. S. 1395 - Stop Unfair Practices in Credit Cards Act Bill would prohibit or reform various credit-card practices. NSBA supported. S. 1617- Fuel Reduction using Electrons to End Dependence On the Mid-East (FREEDOM) Act Bill would provide incentives for the purchase of plug-in electric drive motor vehicles. NSBA supported. S. 1681 Family Medical Leave Insurance Act Legislation to create a fund that would provide up to eight weeks of paid family leave. Mandates employees and employers to fund the plan through payroll taxes. NSBA opposed. S. 1783 - Ten Steps to Transform Health Care in America Act A bill to provide 10 steps to transform health care in America. NSBA supports this legislation to the extent it offers a comprehensive perspective to reforming the health care system to make insurance more affordable for small business owners. However, NSBA opposes the across state line pooling which is included in this proposal. S. 1932 Bill would increase the expenditures for the Small Business Innovation Research and Small Business Technology Transfer programs. NSBA supported. S. 2291- Plain Language in Government Communications Act of 2007 Bill would establish plain language as the standard style for Government documents issued to the public, and for other purposes. NSBA supported. S. 2239 Equity for Our Nations Self-Employed Act of 2007 Would allow self-employed individuals to fully-deduct the cost of their health insurance, thus eliminating the self-employed tax on health care. NSBA supports. S. 2394 - Good Government Contractor Act of 2007 Bill would amend the Internal Revenue Code of 1986 to simplify, modernize, and improve public notice of and access to tax lien information by providing for a national, Internet accessible, filing system for Federal tax liens, and would also repeal the three percent withholding requirement. NSBA supports sections of this bill. S. 2612 - The Small Business Lending Stimulus Act of 2008, Bill would authorize additional funding for SBA lending program and cut borrowing and lending fees. NSBA supported. S. 2636 - Foreclosure Prevention Act of 2008 Bill provides housing reform and includes and extension of the net operating loss carryback rules to allow some money-losing businesses to get refunds of taxes paid during profitable years. NSBA supported. S. 2795 Small Business Health Options Program Act of 2008 Amends the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make coverage more affordable, predictable, and accessible. NSBA supported certain sections of the bill. S. 2886 - Alternative Minimum Tax and Extenders Tax Relief Act of 2008 Bill amends the Internal Revenue Code to extend expiring provisions relating to the alternative minimum tax, individual and business taxpayers, energy conservation, and tax administration. NSBA supported. S. 2902 SBA Reauthorization and Improvements Act of 2008 Bill would reauthorize various parts of the Small Business Administration. NSBA supported. S. 3371 Home Office Deduction Simplification and Improvement Act of 2008 Bill brings clarity to the process of claiming the tax deduction for a home office and directs the Secretary of Treasury to establish an optional standard deduction. NSBA supported. S. 3406 ADA Amendments Act A bill to restore the intent and protections of the Americans with Disabilities Act of 1990. NSBA supports the intent of the ADA, but raised concerns over the potential for additional burdensome regulations being put on small businesses. S. 3408 Comparative Effectiveness Research Act of 2008 A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Comparative Effectiveness Research Trust Fund, and for other purposes. NSBA supports this legislation as a cornerstone to the framework of value-based purchasing and price transparency to consumer of health care services. S. 3554 - Affordable Coverage for Small Employers Act of 2008 A bill to provide employees of small employers with access to quality, affordable health insurance coverage. NSBA supports this legislation to the extent it offers a comprehensive low-income subsidies and tax incentive available to make insurance more affordable for small business owners.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

H.R. 1424 Paul Wellstone Mental Health and Addiction Equity Act H.R. 5501 Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act H.R. 5918 Small Business Health Options Program Act H.R. 6210 Small Business Health Options Program Act H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 7016 Susan B. Anthony Prenatal Nondiscrimination Act H.R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act S. 558 Mental Health Parity Act S. 1693 Wired for Health Care Quality Act S. 2731 Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act S. 2795 Small Business Health Options Program Act S. 3408 Comparative Effectiveness Research Act H. Con. Res. 342 Expressing the sense of Congress that the Food and Drug Administration's (FDA) new policy restricting women's access to medications containing estriol does not serve the public interest. S. Con. Res. 88 Expressing the sense of Congress that the Food and Drug Administration's (FDA) new policy restricting women's access to medications containing estriol does not serve the public interest. Docket No. DEA 218 Electronic Prescriptions for Controlled Substances, CFR Parts 1300, 1304, 1306, 1311 RIN 0991-AB48 Provider Conscience Regulations Request for language in the standards governing ICE detention practices that prohibits the use of shackles or restraints on pregnant women in ICE custody

Client expense: $25,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, U.S. Immigration & Customs Enforcement (ICE)

H.R. 493 Genetic Information Nondiscrimination Act H.R. 2642 Supplemental Appropriations Act H.R. 6210 Small Business Health Options Program Act H.R. 6345 Patient-Controlled Health IT Act H.R. 6357 PRO(TECH)T Act S. 334 Healthy American Act S. 1693 Wired for Health Care Quality Act S. 2795 Small Business Health Options Program Act S. 3230 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act

Client expense: $45,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

HR 507, To establish a grant program to provide vision care to children, and for other purposes, sections as it relates to optometry and health care. HR1343 , To amend the Public Health Service Act to provide additional authorizations of appropriations for the health centers program under section 330 of such Act, and for other purposes, sections as it relates to optometry and health care. HR 1931, The Currency for All Act, sections as it relates to optometry and health care. HR 1884 , To amend the Public Health Service Act to provide for the participation of optometrists in the National Health Service Corps scholarship and loan repayment programs, and for other purposes, sections as it relates to optometry and health care. HR 2012, Contact Lens Consumer Health Protection Act, sections as it relates to optometry and health care. HR 2260, The Health Care Truth and Transparency Act of 2007, sections as it relates to optometry and health care. HR 2915, To amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs, sections as it relates to optometry and health care. S 1117, A bill to establish a grant program to provide vision care to children, and for other purposes, sections as it relates to optometry and health care. S 1693, Wired for Health Care Quality Act, sections as it relates to optometry and health care. S 2408/HR 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act, sections as it relates to optometry and health care. S 2708, A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans, sections as it relates to optometry and health care. S 2795, Small Business Health Options Program (SHOP) Act, sections as it relates to optometry and health care.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Care for Small Businesses S. 2795 H.R. 5918 H.R. 6210 Small Business Health Care

Client expense: $48,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), SENATE

Healthy Families Act, H.R. 1542 Baucus Health Care Proposal Healthy Families Act, S. 910 Emergency Nursing Supply Relief Act, H.R. 5924 James Zadroga 9/11 Health and Compensation Act of 2008, H.R. 7174 Small Business Health Options Program Act, S. 2795 Wellstone Mental Health and Addiction Equity Act of 2007, H.R. 1424 Discussions re health care agencies-- CMS, AHRW, HHS

Client expense: $260,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

See next page for H.R. 1544/S. 907, H.R. 2241/S. 1343, S. 755, H.R. 3544/S. 2479, H.R. 3257/S. 2173, H.R. 1363/S. 771, H.R. 2419, S. 2795/H.R. 5918, S. Res. 549, H.R. 2210/S. 2893 H.R. 1544/S. 907, The Gestational Diabetes Act (GeDi Act) Support entire bill; Legislation expands screening, diagnosis, data collection and treatment of gestational diabetes and the children born from women with gestational diabetes. H.R. 2241/S. 1343, The Diabetes Treatment and Prevention Act of 2007 Support entire bill; Amends the Public Health Service Act to require the Director of the Centers for Disease Control and Preventions (CDC) to establish the division of Diabetes Translation, and provides for pilot programs for diabetes. S. 755, The Diabetes Screening and Medicaid Savings Act of 2007 Support entire bill; Amends title XIX (Medicaid) of the Social Security Act to require states to provide diabetes screening tests under the Medicaid program for adult enrollees with diabetes risk factors and provides a comprehensive package for individuals with diabetes. H.R. 3544/S. 2479, The Catalyst to Better Diabetes Care act of 2007 Support entire bill; To catalyze change in the care and treatment of diabetes in the United States. H.R. 3257/S. 2173, The Fitness Integrated with Teaching Kids Act of 2007 Support entire bill; Amends the Elementary and Secondary Education Act of 1965 to improve standards for physical education. H.R. 1363/S. 771, The Child Nutrition Promotion and School Lunch Protection Act of 2007 Support entire bill; To amend the Child Nutrition Act of 1966 to improve the nutrition and health of schoolchildren by updating the definition of 'food of minimal nutritional value' to conform to current nutrition science and to protect the Federal investment in the national school lunch and breakfast programs. H.R. 2149, to provide for the continuation of agricultural programs throughout fiscal year 2012, and for other purposes. Support only the Fresh Fruit and Vegetable provisions included in the Senate bill which expands the program to $225 million per year through 2012. S. 2795/H.R. 5918, the Small Business Health Options Program of 2008 (SHOP Act) Nuetral but weighed in with recommendations; To amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and self employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible. S. Res. 546, Designating May 2008 as 'National Physical Fitness and Sports Month' and the week of May 1 through May 7, 2008 as 'National Physcial Education and Sports Week' Supported resolution designating National Physical Fitness and Sports Month. H.R. 2210/S. 2863, The Diabetes Prevention Access and Care act of 2007/2008-Support entire bill: would expand resources at NIH and CDC to promote research, treatment, and education regarding diabetes in minority populations. Issues worked on the Hill not yet reflected in legislation: -Small Business Health Insurance Reform; ADA is interested in following the creation of small business health insurance reform legislation and has spoken with offices about legislation not yet introduced. -Health Care Reform; ADA is interested in any reform of the health care system and has spoken with offices about legislation not yet introduced

Client expense: $335,500 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, White House Office

S. 2795/H.R. 6210, Small Business Health Options Program Act, all pooling and tax credit provisions.

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

Government targets: Commerce, Dept of (DOC), Federal Motor Carrier Safety Administration, HOUSE OF REPRESENTATIVES, SENATE, Small Business Administration (SBA), U.S. Trade Representative (USTR)

S. 2795/H.R. 6210, Small Business Health Options Program Act, all pooling and tax credit provisions.

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

Government targets: Commerce, Dept of (DOC), Federal Motor Carrier Safety Administration, HOUSE OF REPRESENTATIVES, SENATE, Small Business Administration (SBA), U.S. Trade Representative (USTR)

See next page for H.R. 2210/S. 2893; H.R. 1544/S. 907; H.R. 2241/S.1343; S.755; H.R. 3257/S. 2173; H.R. 1363/S. 771; H.R. 5918/S. 2795; H.R. 3544/S. 2479; H.R. 5615/S. 3517 H.R. 2210/S. 2893, The Diabetes Prevention Access and Care Act of 2007/2008 Support entire bill: Would expand resources at NIH and CDC to promote research, treatment, and education regarding diabetes in minority populations. (Lobbyists used: Abby Bownas, Meghan Riley) H.R. 1544/S. 907, The Gestational Diabetes Act (GeDi Act) - Support entire bill; Legislation expands screening, diagnosis, data collection and treatment of gestation diabetes and the children born from women with gestational diabetes. (Lobbyists used: Abby Bownas, Kathryn Murray) H.R. 2241/S. 1343, The Diabetes Treatment and Prevention Act of 2007 Support entire bill; Amends the Public Health Service Act to require the Director of the Centers for Disease Control and Prevention (CDC) to establish the Division of Diabetes Translation to eliminate diabetes, allocates funding for the Division of Diabetes Translation, and provides for pilot programs for diabetes. (Lobbyists used: Abby Bownas, Meghan Riley) S. 755, The Diabetes Screening and Medicaid Savings Act of 2007 Support the entire bill; Amends title XIX (Medicaid) of the Social Security Act to require states to provide diabetes screening tests under the Medicaid program for adult enrollees with diabetes risk factors and provides a comprehensive package for individuals with diabetes. (Lobbyist used: Abby Bownas, Kathryn Murray) H.R. 3257/S. 2173, The Fitness Integrated with Teaching Kids Act of 2007 Support entire bill; Amends the Elementary and Secondary Education Act of 1965 to improve standards for physical education. (Lobbyists used: Abby Bownas, Meghan Riley) H.R.1363/S. 771, the Child Nutrition Promotion and School Lunch Protection Act of 2007'. Support entire bill; To amend the Child Nutrition Act of 1966 to improve the nutrition and health of schoolchildren by updating the definition of `food of minimal nutritional value' to conform to current nutrition science and to protect the Federal investment in the national school lunch and breakfast programs. (Lobbyists used: Abby Bownas, Meghan Riley) H.R. 5918/S. 2795, the Small Business Health Options Program Act of 2008 (SHOP Act). Neutral but continue conversations about possible changes; To amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible. (Lobbyist used: Kathryn Murray, Abby Bownas, Ken Van Pool, Jim Schlicht) H.R. 3544/S. 2479, the Catalyst to Better Diabetes Care Act of 2007 Support the entire bill; to catalyze change in the care and treatment of diabetes in the United States. (Lobbyists used: Abby Bownas) H.R. 5615/S. 3517, the Group Health Plans Prosthetic Parity Act of 2007 Support the entire bill; to ensure equal treatment for patients who have suffered limb loss. (Lobbyist used: Abby Bownas, Meghan Riley) Issues worked on the Hill not yet reflected in legislation: Small Business Health Insurance Reform; ADA is interested in following the creation of small business health insurance reform legislation and has spoken with offices about legislation not yet introduced. Lobbyist used: Abby Bownas, Kathryn Murray, Ken Van Pool. Health Care Reform; ADA is interested in any reform of the health care system and has spoken with offices about legislation not yet introduced. Lobbyist used: Jim Schlicht, Abby Bownas, Kathryn Murray, Meghan Riley, Ken Van Pool, Jane Loewenson, Lisa Foster. Transportation Reauthorization; ADA is interested in the drafting of the successor to SAFETEA-LU transportation reauthorization legislation. Support developing performance based outcomes related to public health for the next transportation bill, including physical activity and Safe Routes to School.

Client expense: $158,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Motor Carrier Safety Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Generic Biologics (S. 623; S. 1695; H.R. 1038); Health system / insurance / ERISA reform (H.R. 676; H.R. 506; H.R. 2034; H.R. 3163; S. 334; S. 1783; S. 1019; S. 2818; S. 1886; S. 2795; H.R. 6210); Health cost savings / comparative effectiveness / wellness promotion (H.R. 2184; H.R. 3162; S. 1342; S. 1753; S. 1754; H.R. 3717; H.R. 853; H.R. 2633; S. 3408); Health IT (S. 1693; H.R. 5442; H.R. 6357; H.R. 6898); High Risk Pools (S. 3230, Labor-HHS Approps.); Medicare (Medicare Advantage, electronic prescribing, sales and marketing of Medicare private insurance products (H.R. 3162, S 3101, HR 6331, HR 4296, S. 2408); medcal liability reform (S. 243, S 2662, HR 2580, HR 5480, insurance regulation (S 40, HR 5611, HR 5840), long term care (S 1758, S 2337, HR 3363); SCHIP reauthorization (HR 976, HR 3963); Health insurance tax treatment (HRAs, HSAs, FSAs, Health Care Tax Credit--HR 3920, HR 3943, HR 4341, S 1739, S 1848, HR 5719); Small business / national pooling of insurance health reform (S. 2795; H.R. 6210; H.R. 6582)

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

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

H.R. 25 - Fair Tax Act or 2007 Legislation to abolish the Internal Revenue Service and enacting a national sales tax. NSBA supported. H. R. 731 - National Small Business Regulatory Assistance Act of 2007 Bill would require the SBA to establish a program providing regulatory-compliance assistance to small businesses. NSBA supported. H.R. 1023 - Withholding Tax Relief Act of 2007 A bill to repeal a provision designed to increase federal tax revenue by $7 billion over ten years. Repeal the new mandatory three percent withholding requirement on all payments for goods and services made to federal, state and local contractors. NSBA supports. H.R. 1112 - Stealth Tax Relief Extension Act of 2007 The legislation increases the exemption from the alternative minimum tax for individual taxpayers in 2007 and extends through 2007 the allowance of certain nonrefundable tax credits against alternative minimum tax liability. NSBA supported. H.R. 1424 - Emergency Economic Stabilization Act of 2008 Bill addressed the expiration of popular tax provisions such as the AMT patch, research and development tax credits and various other credits and deductions designed to encourage renewable energies. NSBA supported. H.R. 1677 Taxpayer Protection Act of 2007 Bill gives IRS the right to deny information to tax preparers and lenders who might be contemplating predatory refund anticipation loans (RALs). It also includes provisions on the earned income tax credit and individual retirement accounts. NSBA supported. H.R. 1873 Small Business Fairness in Contracting Act of 2007 Bill would improve federal procurement opportunities for small businesses. NSBA supported. H.R. 2205 Retirement Security for Life Act To amend the Internal Revenue Code of 1986 to encourage guaranteed lifetime income payments from annuities and similar payments of life insurance proceeds at dates later than death by excluding from income a portion of such payments. NSBA supports retirement options for its employees, but NSBA has remained largely neutral on this proposal. H.R. 2380 - Death Tax Repeal Permanency Act of 2007 To make permanent the repeal of the estate tax after 2010. NSBA supported. H.R. 2419 - Farm, Nutrition, and Bioenergy Act of 2007 Bill includes tax incentives for farms, energy and conservation initiatives. NSBA opposed certain revenue-offsets in the bill. H.R. 2727 Small Business SOX Compliance Extension Act It would extend the current exemption by at least one year for small businesses to comply with the Sarbanes-Oxley internal controls reporting requirements. NSBA supported. H.R. 3163 - The Healthy Americans Act Broad health care reform that includes an individual mandate, creation of state Health Help Agencies, subsidies for low-income individuals and changes tax-treatment of health care and health insurance expenditures. NSBA supported sections of the bill. H.R. 3170 Capital Gains and Estate Tax Relief Act of 2007 The bill permanently reduces the capital gains tax to 15 percent and the estate tax exemption will be $3.5 million in 2009 and will increase $250,000 per year until it reaches $5 million 2015. NSBA supported. H.R. 3221 - New Direction for Energy Independence, National Security, and Consumer Protection Act The bill provides economic aid to the housing industry and amend the Internal Revenue Code of 1986 to provide tax incentives for the production of renewable energy and energy conservation. NSBA opposed certain revenue-offsets in the bill. H.R. 3548 - Plain Language in Government Communications Act of 2007 Bill would establish plain language as the standard style for Government documents issued to the public, and for other purposes. NSBA supported. H.R. 3567 - The Small Business Investment Expansion Act of 2007 Bill would expand the ability of venture capital-owned businesses to participate in small-business programs. NSBA opposed. H.R. 3660 - Equity for Our Nations Self-Employed Act of 2007 Would allow self-employed individuals to fully-deduct the cost of their health insurance, thus eliminating the self-employed tax on health care. NSBA supported. H.R. 4008 - Credit and Debit Card Receipt Clarification Act of 2007 Bill provides technical corrections to the definition of willful noncompliance in regard to unintentional violations of the Fair Credit Reporting Act. NSBA supported. H.R. 4458 - The Small Business Regulatory Improvement Act Bill seeks to improve the Regulatory Flexibility Act and reduce the regulatory burden borne by Americas small businesses. NSBA supported. H.R. 5140 - Economic Stimulus Act of 2008 Bill provides economic stimulus through recovery rebates to individuals, incentives for business investment, and an increase in conforming and FHA loan limits. NSBA supported. H.R. 5244 - The Credit Cardholders Bill of Rights Bill would prohibit or reform various credit-card practices. NSBA supported. H.R. 5351 - Renewable Energy and Energy Conservation Tax Act Bill would extend a range of renewable energy tax incentives NSBA supported. H.R. 5719 - Taxpayer Assistance and Simplification Act of 2008 Bill amends the Internal Revenue Code of 1986 to conform return preparer penalty standards, delay implementation of withholding taxes on government contractors, enhance taxpayer protections, and assist low-income taxpayers. NSBA supported certain provisions of the measure. H.R. 5819 SBIR STTR Reauthorization Act Bill would reauthorize the Small Business Innovation Research (SBIR) program. NSBA supported. H.R. 6049 - Renewable Energy and Job Creation Act of 2008 Bill amends the Internal Revenue Code of 1986 to provide incentives for energy production and conservation, extend certain expiring tax provisions, and provide individual income tax relief. NSBA supported. H.R. 6210 - Small Business Health Options Program Act of 2008 Amends the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make coverage more affordable, predictable, and accessible. NSBA supported certain sections of the bill. H.R. 6214 - Home Office Deduction Standardization Act of 2008 It amends the Internal Revenue Code to allow a taxpayer who uses a residence to conduct a trade or business a standard tax deduction equal to the lesser of $1,500 or the taxpayer's gross trade or business income derived from the business use of such residence. NSBA supported. H.R. 6275 - Alternative Minimum Tax Relief Act of 2008 Bill provides individuals temporary relief from the alternative minimum tax. NSBA supported bill, but opposed offsets. H.R. 6499 Sensible Tax Act of 2008 Beginning in 2009, the legislation would permanently exclude the first $2 million ($4 million for a couple) of an estates value from being subject to any tax and subsequently be adjusted for inflation. The measure would ensure that the surviving spouse is entitled to the $2 million to which the deceased spouse was entitled. NSBA supported. H.R. 6582 - Small Business CHOICE Act of 2008 To encourage the development of small business cooperatives for healthcare options to improve coverage for employees (CHOICE) including through a small business CHOICE tax credit. NSBA supports elements of this legislation to the extent it addresses rising health care cost and insurance availability for small business owners. However, NSBA maintains reservations about the use of cooperatives to achieve this. H.R. 6601 Small Business Tax Modernization Act of 2008 Bill creates a standard home office deduction, removes cell phones from listed property, allows nonresident aliens to be S corporation shareholders, increases the deduction for business meals and entertainment for qualified small businesses, and reduces the recovery period for depreciation of heating, ventilation, air conditioning, and refrigeration (HVACR) equipment. NSBA supported. H.R. 6633 - Employee Verification Amendment Act of 2008 To evaluate and extend the basic pilot program for employment eligibility confirmation and to ensure the protection of Social Security beneficiaries. NSBA supports the employment of legal employees, but remains cautious of mandating a system such as E-verify on small businesses owners due to burdensome administrative task, unwarranted penalties and historical technical errors with the E-verify system. H.R. 6983 - Paul Wellstone Mental Health and Addiction Equity Act of 2008 Would require health plans that offer mental health benefits to cover the same mental health and addiction disorders that are included in the Federal Employee Health Benefits Program (FEHBP). NSBA opposed. H.R. 7005 Alternative Minimum Tax Relief Act of 2008 Bill would amend the Internal Revenue Code of 1986 to provide alternative minimum tax relief for individuals for 2008. NSBA supported. H.R. 7006 Disaster Tax Relief Act of 2008 Provides relief to taxpayers affected by Federally-declared disasters nationwide. NSBA supported the tax relief provisions. H.R. 7060 - Renewable Energy and Job Creation Tax Act of 2008 Bill includes an extension of individual and business tax provisions and energy tax incentives. NSBA supported. H.R. 7074 Home Office Tax Deduction Simplification Act Bill brings clarity to the process of claiming the tax deduction for a home office and directs the Secretary of Treasury to establish an optional standard deduction. NSBA supported. S. 55 - Individual Alternative Minimum Tax Repeal Act of 2007 The measure repeals the alternative minimum tax on individuals. NSBA supported. S. 102 A bill to extend and expand relief from the alternative minimum tax and to repeal the extension of the lower rates for capital gains and dividends for 2009 and 2010. The legislation increases the exemption from the alternative minimum tax for individual taxpayers in 2007 and extends through 2007 the allowance of certain nonrefundable tax credits against alternative minimum tax liability. NSBA supported. S. 334 The Healthy Americans Act Broad health care reform that includes an individual mandate, creation of state Health Help Agencies, subsidies for low-income individuals and changes tax-treatment of health care and health insurance expenditures. NSBA supported sections of the bill S.558 Mental Health Parity Act of 2007 Legislation would require insurance companies to offer the same level of financial coverage for mental health care as they do for other medical care. NSBA opposed S. 777 Withholding Tax Relief Act of 2007 A bill to repeal a provision designed to increase federal tax revenue by $7 billion over ten years. Repeal the new mandatory 3 percent withholding requirement on all payments for goods and services made to federal, state and local contractors. NSBA supports. S. 1010 Retirement Security for Life Act To amend the Internal Revenue Code of 1986 to encourage guaranteed lifetime income payments from annuities and similar payments of life insurance proceeds at dates later than death by excluding from income a portion of such payments. NSBA supports retirement options for its employees, but NSBA has remained largely neutral on this proposal. S. 1395 - Stop Unfair Practices in Credit Cards Act Bill would prohibit or reform various credit-card practices. NSBA supported. S. 1681 Family Medical Leave Insurance Act Legislation to create a fund that would provide up to eight weeks of paid family leave. Mandates employees and employers to fund the plan through payroll taxes. NSBA opposed. S. 1783 - Ten Steps to Transform Health Care in America Act A bill to provide 10 steps to transform health care in America. NSBA supports this legislation to the extent it offers a comprehensive perspective to reforming the health care system to make insurance more affordable for small business owners. However, NSBA opposes the across state line pooling which is included in this proposal. S. 1932 Bill would increase the expenditures for the Small Business Innovation Research and Small Business Technology Transfer programs. NSBA supported. S. 2291- Plain Language in Government Communications Act of 2007 Bill would establish plain language as the standard style for Government documents issued to the public, and for other purposes. NSBA supported. S. 2239 - Equity for Our Nation's Self-Employed Act of 2007 Would allow self-employed individuals to fully-deduct the cost of their health insurance, thus eliminating the self-employed tax on health care. NSBA supports. S. 2394 - Good Government Contractor Act of 2007 Bill would amend the Internal Revenue Code of 1986 to simplify, modernize, and improve public notice of and access to tax lien information by providing for a national, Internet accessible, filing system for Federal tax liens, and would also repeal the three percent withholding requirement. NSBA supports sections of this bill. S. 2612 - The Small Business Lending Stimulus Act of 2008, Bill would authorize additional funding for SBA lending program and cut borrowing and lending fees. NSBA supported. S. 2636 - Foreclosure Prevention Act of 2008 Bill provides housing reform and includes and extension of the net operating loss carryback rules to allow some money-losing businesses to get refunds of taxes paid during profitable years. NSBA supported. S. 2795 Small Business Health Options Program Act of 2008 Amends the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make coverage more affordable, predictable, and accessible. NSBA supported certain sections of the bill. S. 2886 - Alternative Minimum Tax and Extenders Tax Relief Act of 2008 Bill amends the Internal Revenue Code to extend expiring provisions relating to the alternative minimum tax, individual and business taxpayers, energy conservation, and tax administration. NSBA supported. S. 2902 SBA Reauthorization and Improvements Act of 2008 Bill would reauthorize various parts of the Small Business Administration. NSBA supported. S. 3371 Home Office Deduction Simplification and Improvement Act of 2008 Bill brings clarity to the process of claiming the tax deduction for a home office and directs the Secretary of Treasury to establish an optional standard deduction. NSBA supported. S. 3406 ADA Amendments Act A bill to restore the intent and protections of the Americans with Disabilities Act of 1990. NSBA supports the intent of the ADA, but raised concerns over the potential for additional burdensome regulations being put on small businesses. S. 3408 Comparative Effectiveness Research Act of 2008 A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Comparative Effectiveness Research Trust Fund, and for other purposes. NSBA supports this legislation as a cornerstone to the framework of value-based purchasing and price transparency to consumer of health care services. S. 3554 - Affordable Coverage for Small Employers Act of 2008 A bill to provide employees of small employers with access to quality, affordable health insurance coverage. NSBA supports this legislation to the extent it offers a comprehensive low-income subsidies and tax incentive available to make insurance more affordable for small business owners. S. 3406 ADA Amendments Act A bill to restore the intent and protections of the Americans with Disabilities Act of 1990. NSBA supports the intent of the ADA, but raised concerns over the potential for additional burdensome regulations being put on small businesses. S. 3682 - Small Business Energy Innovation Act Bill would authorize grants and loan guarantees to small businesses developing and manufacturing energy-efficient technologies. NSBA supported.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

See attached addendum for General Lobbying Issue Area: HCR-Healthcare Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD 10 Implementation: HR1368 "Personalized Health Information Act of 2007;" S1783 and S1693 "Wired for Health Care Quality Act;" HR3800 "Promoting Health Information Technology Act;" HR2406 "Healthcare Information Technology Enterprise Integration Act;" HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured; Health Disparities; Connectors/Virtual Connectors; S1019 "Health Care Choice Act of 2007;" S334 and HR3163 "Healthy Americans Act;" S2795 "Small Business Health Options Program Act of 2008" Comparative Effectiveness Funding: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act;" S3408 "Comparative Effectiveness Research Act of 2008" SCHIP; HR976 and HR3963 "SCHIP Extension Bill"

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

HR 2132, HR 1012, HR 324, HR 241, S 2808, HR 2737, S 2795, HR 5918, HR 6210 - ensuring parity and access for podiatric physicians in small business health plan reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2795, H.R. 6210 -- Small Business Options Program (SHOP) Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Generic Biologics (s. 623; S. 1695; H.R. 1038); Health system/Insurance/ ERISA reform (H.R. 676; H.R. 506; H.R. 2034; H.R. 3163; S. 334; S. 1783; S. 1019; S. 2818; S. 1886; S. 2795; H.R. 6210); Health cost savings/comparative effectiveness/wellness promotion (H.R. 2184; H.R. 3162; S. 1342; S. 1753; S. 1754; S. 3408; H.R. 3717; H.R. 853; H.R. 2633); Health IT (S. 1693; H.R. 5442; H.R. 6357; H.R. 6898); High risk pools (S. 3230, Labor HHS Approps.); Medicare (Medicare Advantage, electronic prescribing, sales and marketing of Mediare-related private insurance products - H.R. 3162; S. 3101; H.R. 6331; H.R. 4296; s. 2408); medical liability reform (S. 243; S. 2662; H.R. 2580; H.R. 5480); insurance regulation (S. 40; H.R. 5611; H.R. 5840); Long term care (S. 2337, S. 1758; H.R. 3363); SCHIP reauthorization (H.R. 976); Health Insurance Tax Treatment (HSAs, FSAs, HRAs, Health Coverage Tax Credit - H.R. 3920; H.R. 3943; H.R. 4341; S. 1739; S. 1848; H.R. 5719); small business/national pooling of insurance health reform (s. 2795; H.R. 6210; H.R. 6582)

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

Government targets: Administration on Aging, Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Generic Biologics (S. 623; S. 1695; H.R. 1038); Health system / insurance / ERISA reform (H.R. 676; H.R. 506; H.R. 2034; H.R. 3163; S. 334; S. 1783; S. 1019; S. 2818; S. 1886; S. 2795; H.R. 6210); Health cost savings / comparative effectiveness / wellness promotion (H.R. 2184; H.R. 3162; S. 1342; S. 1753; S. 1754; H.R. 3717; H.R. 853; H.R. 2633; S. 3408); Health IT (S. 1693; H.R. 5442; H.R. 6357; H.R. 6898); High Risk Pools (S. 3230, Labor-HHS Approps.); Medicare (Medicare Advantage, electronic prescribing, sales and marketing of Medicare-related private insurance products H.R. 3162; S. 3101; H.R. 6331; H.R. 4296; S. 2408); medical liability reform (S. 243; S. 2662; H.R. 2580; H.R. 5480); insurance regulation (S. 40; H.R. 5611; H.R. 5840); Long Term Care (S. 1758; S. 2337; H.R. 3363); SCHIP reauthorization (H.R. 976; H.R. 3963); Health Insurance Tax Treatment (HSAs, FSAs, HRAs, Health Coverage Tax Credit H.R. 3920; H.R. 3943; H.R. 4341; S. 1739; S. 1848; H.R. 5719); Small business / national pooling of insurance health reform (S. 2795; H.R. 6210; H.R. 6582)

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

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

Healthy Families Act, H.R. 1542 Baucus Health Care Proposal Healthy Families Act, S. 910 Emergency Nursing Supply Relief Act, H.R. 5924 James Zadroga 9/11 Health and Compensation Act of 2008, H.R. 7174 Small Business Health Options Program Act, S. 2795 Wellstone Mental Health and Addiction Equity Act of 2007, H.R. 1424 Discussions re health care agencies-- CMS, AHRW, HHS

Client expense: $260,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

See attached Support legislation (S 2818) that would allow small companies to pool together collectively across state lines and purchase health plans through trade associations. Support legislation (S 1783) which outlines 10 steps to transform health care in America. Support S 2795 & HR 6210, the Small Business Health Options Program Act

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

Government targets: Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), SENATE

Wired for Health Care Quality Act, S. 1693, Health Information Technology; S. 1019, Universal Health Care Choice and Access Act, Health tax reform; S. 1886, Every American Insured Health Act, Health tax reform; S. 334, Healthy Americans Act, all provisions; S. 1544, Medicare Quality Enhancement Act, all provisions; H.R. 1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007, mental health parity; S. 558, Mental Health Parity Act of 2007, mental health parity; S. 1753, Healthy Workforce Act of 2007, wellness and prevention provisions; S. 1754, To amend the Public Health Service Act to provide for a workplace wellness education campaign and an evaluation of employer-based wellness programs, and for other purposes, wellness and prevention provisions; H.R. 3370, Medicare Quality Enhancement Act of 2007, wellness and prevention provisions; ERISA Waivers; Health care reform; Health Savings Accounts; Medicare Advantage Plans; S. 2795/H.R. 5918, Small Business Health Options Program Act of 2008, all provisions; H.R. 7187/S. 3575, Labeling Education and Nutrition Act of 2008, all provisions

Client expense: $500,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Employment Standards Administration, Environmental Protection Agency (EPA), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Intl Trade Administration (ITA), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Credit Union Administration (NCUA), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Thrift Supervision (OTS), Office of the Comptroller of the Currency (OCC), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Secret Service, U.S. Trade Representative (USTR), White House Office

Monitor and lobby on healthcare quality, cost, and access and related health care reform efforts, including related provisions in S. 2795 and HR 5918, Small Business Health options Program Act, S. 2818 Small Business Health Plans Act. Health Information Technology and related provisions in HR 6357, Protecting Records, Optimizing Treatment, and Easing Communications through Health Care Technology Act and HR 6898, The Health Care Information Technology Act. Medicaid registration moratorium legislation, including provisions in HR 5613 Protecting the Medicaid Safety Net, and S. 2819 Economic Recovery in Health Care Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1328/ S 1200, "Indian Health Care Improvement Act Reauthorization Bill," regarding sections 403 and 407 of the House version and section 415 of the Senate version; HR 4460/ S 2477, "Health Care Choice Act," monitoring activity regarding all provisions; HR 506, "The Health Partnership Through Creative Federalism Act," monitoring activity regarding all provisions; S 1758, "Community Living Assistance Services and Supports Act," regarding all provisions; S 1693, "The Wired for Health Care Quality Act," regarding all provisions; S 504 "Long-Term Care Trust Account Act of 2007", regarding all provisions; HR 2582, "Qualified Long-Term Care Fairness Act of 2007", regarding all provisions; S 1758, "Community Living Assistance Services and Supports Act", regarding all provisions; HR 5559 "Long-Term Care Retirement and Security Act of 2008", regarding all provisions; HR 493, "Genetic Nondiscrimination Act of 2007", regarding all provisions; S 334 "Healthy Americans Act", regarding all provisions; HR 6210/ S2795, "SHOP Act", regarding all provisions; HR 6357, "PRO(TECH)T Act of 2008", regarding all provisions.

Client expense: $830,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)

INS (Legislative): H.R. 241: Association Health Plans (Johnson); H.R. 758: Breast Cancer Patient Protection Act (DeLauro) (continued) INS (Legislative) (cont.) H.R. 1081: Insurance Industry Competition Act (DeFazio); H.R. 1282: Medigap Access Improvement Act (English); H.R. 1424: Paul Wellstone Mental Health and Addiction Equity Act (Kennedy); H.R. 2412: Equity in Prescription Insurance and Contraceptive Coverage Act (Lowey); H.R. 2676: Access to Cancer Clinical Trials Act (Pryce); H.R. 2842: Childrens Health Protection Act (Schwartz); H.R. 2851: Michelles Law (Hodes) (provisions relating to continuity of coverage for college students on medical leave); H.R. 3001: Community Living Assistance Services and Supports Act (Pallone); H.R. 3195: ADA Amendments Act (Hoyer); H.R. 3200: National Insurance Act (provisions relating to regulatory reform) (Bean); H.R. 3425: Cancer Screening Coverage Act (Maloney); H.R. 4460: Health Care Choice Act (provisions relating to health insurance reforms in individual market) (Shadegg); H.R. 5550: Coverage for Young Adult Dependents of Federal Employees (Davis); H.R. 5781: Federal Employees Paid Parental Leave Act (Maloney) (provisions relating to disability study); H.R. 5840: Insurance Information Act (Kanjorski) (provisions relating to federal Office of Insurance Information); H.R. 5938: Identity Theft Enforcement and Restitution Act (Conyers); H.R. 6049: Energy Improvement and Extension Act (provisions relating to mental health parity); H.R. 6071: Health Care Consumer Protection Act (Forbes) (provisions relating to reinstatement of health insurance following nonpayment of premiums); H.R. 6142: Lawsuits Against Employer-Sponsored Disability Benefit Plans (Andrews); H.R. 6210: Small Business Health Options Program Act (Kind-English); H.R. 6528: Health Insurance Coverage Protection Act (Eshoo) (provisions relating to limitations on lifetime limits); H.R. 6582: Small Business CHOICE Act (Velazquez) (provisions relating to health insurance); H.R. 6908: Health Insurance Restrictions and Limitations Clarifications Act (Burgess) (provisions relating to disclosure rules for coverage exclusions); H.R. 6983: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (Kennedy) (provisions relating to mental health parity); H.R. 7129: Several Approaches to Reduce the Uninsured Act (Andrews) (relating to state regulation of employer-sponsored health benefits); S. 40: National Insurance Act (provisions relating to regulatory reform) (Sununu); S. 46: Affordability in the Individual Market Act (provisions relating to HSAs) (Ensign); S. 239: Notification of Risk to Personal Data Act (Feinstein); S. 400: Michelle's Law (provisions relating to continuity of coverage for college students on medical leave) (Sununu); S. 459: Breast Cancer Patient Protection Act (Snowe); S. 495: Personal Data Privacy and Security Act (Leahy); S. 558: Mental Health Parity Act (Domenici); S. 616: HIPAA Recreational Injury Technical Correction Act (Collins); S. 618: Insurance Industry Competition Act (Leahy); S. 1076: HIPAA Recreational Injury Technical Correction Act (Burgess); S. 1178: Identity Theft Protection Act (Inouye); S. 1260: Data Security Act (Carper); S. 1298: Healthy Businesses, Healthy Workers Reinsurance Act (Kerry); S. 1588: Children's Access to Reconstructive Evaluation and Surgery Act (Landrieu); S. 1758: Community Living Assistance Services and Supports Act (Kennedy); S. 1814: Health Information Privacy and Security Act (Leahy); S. 2168: Identify Theft Enforcement and Restitution Act (Leahy); S. 2236: Preexisting Condition Exclusion Patient Protection Act (Rockefeller); S. 2268: Long Term Care Insurance Integrity Act (Klobuchar); S. 2477: Health Care Choice Act (DeMint); S. 2706: Health Insurance Coverage Protection Act (Dorgan); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2818: Small Business Health Plans Act (Enzi); S. 2948: Small Business Empowerment Act (Brown) (provisions relating to health coverage for small employers); S. 2999: Access to Cancer Clinical Trials Act (Brown); S. 3068: Equity in Prescription Insurance and Contraceptive Coverage Act (Snowe); S. 3115: Childrens Health Protection Act (Lautenberg); S. 3335: Jobs, Energy, Families, and Disaster Relief Act (provisions relating to mental health parity); S. 3554: Affordable Coverage for Small Employers Act (Smith) (provisions relating to insurance reforms, tax credits); S. 3559: Continuing Coverage Act (Coleman) (relating to third party review for rescission decisions); S. 3712: Mental Health Parity (Kennedy) (relating to a technical correction); DRAFT Senate Bill (Grassley) relating to disclosure of employee health insurance costs; Draft Senate Health Care Reform Proposal (Baucus) (relating to access, quality, and affordability issues). INS (Regulatory) Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; crossover fees for Medigap claims; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials; and implementation of the Mental Health Parity Act requirements.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); H.R. 5683: GAO Act (provisions relating to access to Medicare part C/part D data) (Davis); H.R. 5998: Protecting Children's Health Coverage Act (Pallone); H.R. 6331: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) (Rangel-Dingell); H.R. 6388: GAO Improvement Act (provisions relating to access to Medicare part C/part D data) (Waxman); H.R. 6359: Medicare Beneficiary Protection Act (Biggert); H.R. 6365: Medicare Special Needs Plans Extension and Amendments Act (Kind); H.R. 7077: QI Program Supplemental Funding Act (Dingell) (provisions relating to cost sharing assistance for low-income Medicare beneficiaries); H.R. 7197: Medicare Advantage Funding (Gonzalez) (provisions relating to limiting increases in Medicare Advantage payment rates); H.Res. 1368 (provisions relating to Medicare Funding Warning); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1589: Drug Rebate Equalization Act (Bingaman) (provisions relating to Medicaid drug rebates); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2819: Economic Recovery in Health Care Act (provisions relating to Medicaid funding) (Rockefeller); S. 3101: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) (Baucus); S. 3560: QI Program Supplemental Funding Act (Baucus) (provisions relating to cost sharing assistance for low-income Medicare beneficiaries); S. 3604: Emergency Supplemental Appropriations Act (provisions relating to Medicaid FMAP); S. 3656: Preserving Access to Healthcare Act (Schumer) (provisions relating to Medicare and Medicaid regulation); S. 3869: Economic Stimulus (Reid) (provisions relating to Medicaid FMAP and Medicaidd MCO provider taxes); S. 3710: Medicare Early Access Act (Rockefeller) (provisions relating to Medicare "buy-in" option); and S.J.Res. 44 (provisions relating to blocking implementation of SCHIP requirements). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including audit and encounter data issues), bidding and payment issues (including MA coding intensity, Part D reinsurance, low income subsidies, application process, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality meaasures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration issues for Special Needs Plans (SNPs); Federal premption of State authority over MA and Part D plans, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting inititiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of

S. 334/H.R. 6444, Healthy Americans Act (provisions related to Medicaid coverage and low-income access issues) S. 2795/H.R. 5918, SHOP Act, Small Business Health Options Program Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Supported the Small Business Health Options Program Act of 2008 (SHOP) (S. 2795) and the Small Business Health Plans Act (S. 2818) as a feasible mechanism for providing health insurance to the nation's small business employees and employers.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health insurance coverage for small businesses and the self-employed S.2795--The Small Business Health Options Program

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

Government targets: SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured; Connectors/Virtual Connectors, SIMs; S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Mental Health Parity: S3712 "A Bill to make a technical correction in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Funding: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only, HR2184 "Enhanced Health Care Value for All Act"; S3408 "Comparative Effectiveness Research Act of 2008" Health Savings Accounts/Medical Savings Accounts SCHIP; HR976 and HR3963 "SCHIP Extension Bill" HR2851 and S400 "Michelle's Law" Health Disparities; Wellness: Technical Corrections to S1753 Healthy Workforce Act of 2007

Client expense: $1,920,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Mental Health Parity, Health Savings Accounts/Medical Savings Accounts, Small Group Health Care Reform Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured; Health Disparities; Connectors/Virtual Connectors; S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Mental Health Parity: S3712 "A Bill to make a technical correction in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" S3408 "Comparative Effectiveness Research Act of 2008" Health Savings Accounts/Medical Savings Accounts SCHIP; HR976 and HR3963 "SCHIP Extension Bill"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Mental Health Parity, Health Savings Accounts/Medical Savings Accounts, Small Group Health Care Reform Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured; Health Disparities; Connectors/Virtual Connectors; S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Mental Health Parity: S3712 "A Bill to make a technical correction in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" S3408 "Comparative Effectiveness Research Act of 2008" Health Savings Accounts/Medical Savings Accounts SCHIP; HR976 and HR3963 "SCHIP Extension Bill"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1424, The Emergency Economic Stabilization Act of 2008; S. 2795/H.R. 6210, Small Business Health Options Program (SHOP) Act of 2008; H.R.6582, the Small Business Cooperative for Healthcare Options to Improve Coverage for Employees (CHOICE) Act of 2008; S. 2608 Amends Small Business Act Section 8(m), The Women's Procurement Program; S. 2239/H.R. 3660 Equity for Our Nation's Self-Employed Act; H.R. 1023/S.777 Permanent Repeal of Section 511 of the Tax Code; S.1010/H.R. 2205, The Retirement Security for Life Act; S. 3001 FY 2009 Defense Authorization Bill; H.R. 2638 Continuing Resolution; SBA Proposed Rule on the Women's Procurement Program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Small Business Administration (SBA)

Generic Biologics (S. 623; S. 1695; H.R. 1038); Health system / insurance / ERISA reform (H.R. 676; H.R. 506; H.R. 2034; H.R. 3163; S. 334; S. 1783; S. 1019; S. 2818; S. 1886; S. 2795; H.R. 6210); Health cost savings / comparative effectiveness / wellness promotion (H.R. 2184; H.R. 3162; S. 1342; S. 1753; S. 1754; H.R. 3717; H.R. 853; H.R. 2633); Health IT (S. 1693; H.R. 5442; H.R. 6357; H.R. 6898); High Risk Pools (S. 3230, Labor-HHS Approps.); Medicare (Medicare Advantage, electronic prescribing, sales and marketing of Medicare-related private insurance products H.R. 3162; S. 3101; H.R. 6331; H.R. 4296; S. 2408); medical liability reform (S. 243; S. 2662; H.R. 2580; H.R. 5480); insurance regulation (S. 40; H.R. 5611; H.R. 5840); Long Term Care (S. 2337; H.R. 3363); SCHIP reauthorization (H.R. 976); Health Insurance Tax Treatment (HSAs, FSAs, HRAs, Health Coverage Tax Credit H.R. 3920; H.R. 3943; H.R. 4341; S. 1739; S. 1848; H.R. 5719); Small business / national pooling of insurance health reform (S. 2795; H.R. 6210; H.R. 6582); Comparative effectiveness (S. 3408); SCHIP reauthorization (H.R. 976; H.R. 3963)

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

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

H.R.150: To prevent the nondisclosure of employer-owned life insurance coverage of employees as an unfair trade practice under the Federal Trade Commission Act, and for other purposes. H.R.377: To amend the Internal Revenue Code of 1986 to increase the dollar limitation on employer-provided group term life insurance that can be excluded from the gross income of the employee. H.R.385: To amend title II of the Social Security Act to eliminate reconsideration as an intervening step between initial benefit entitlement decisions and subsequent hearings on the record on such decisions. H.R.537: To establish a bipartisan commission on insurance reform. H.R.1065: To streamline the regulation of nonadmitted insurance and reinsurance, and for other purposes. H.R.1081: To further competition in the insurance industry. H.R. 2622: To amend title I of the Employee Retirement Income Security Act of 1974 to require de novo review of claims determinations made by employee benefit plans. H.R.2713: To amend title II of the Social Security Act to authorize waivers by the Commissioner of Social Security of the 5-month waiting period for entitlement to benefits based on disability in cases in which the Commissioner determines that such waiting period would cause undue hardship to terminally ill beneficiaries, and to provide for a study by the Commissioner regarding possible improvements in disability claims processing. H.R.2933: To amend title II of the Social Security Act to provide that the reductions in Social Security benefits which are required in the case of spouses and surviving spouses who are also receiving certain government pensions shall be equal to the amount by which two-thirds of the total amount of the combined monthly benefit (before reduction) and monthly pension exceeds $1,200, adjusted for inflation. H.R.2944: to amend title II of the Social Security Act to provide that the eligibility requirement for disability insurance benefits under which an individual must have 20 quarters of Social Security coverage in the 40 quarters preceding a disability shall not be applicable in the case of a disabled individual suffering from a covered terminal disease. H.R.3046: To amend the Social Security Act to enhance Social Security account number privacy protections, to prevent fraudulent misuse of the Social Security account number, and to otherwise enhance protection against identity theft, and for other purposes. H.R.3200: To authorize the issuance of Federal charters and licenses for carrying on the sale, solicitation, negotiation, and underwriting of insurance or any other insurance operations, to provide a comprehensive system for the Federal regulation and supervision of national insurers and national agencies, to provide for policyholder protections in the event of an insolvency or the impairment of a national insurer, and for other purposes. H.R.3271: To prohibit the solicitation and display of Social Security account numbers, and for other purposes. H.R.3363: To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R.4181: To reform Social Security retirement and Medicare by establishing a Personal Social Security Savings Program to create a safer, healthier, more secure, and more prosperous retirement for all Americans and to reduce the burden on young Americans. H.R.5611: To reform the National Association of Registered Agents and Brokers, and for other purposes. H.R.5792: To amend the Liability Risk Retention Act of 1986 to increase insurance competition and available coverage for consumers. H.R.5840: To establish an Office of Insurance Information in the Department of the Treasury. H.R.6071: to amend the Public Health Service Act to require reinstatement upon payment of all premiums due of group or individual health insurance coverage terminated by reason of nonpayment of premiums. H.R.6210: to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible S. 40: to authorize the issuance of federal charters and licenses for carrying on the sale, solicitation, negotiation, and underwriting of insurance or any other insurance operations, to provide a comprehensive system for the federal regulation and supervision of national insurers and national agencies, to provide for policyholder protections in the event of an insolvency or the impairment of a national insurer, and for other purposes. S.292: A bill to establish a bipartisan commission on insurance reform. S.618: A bill to further competition in the insurance industry. S.1736: to amend title II of the Social Security Act to provide that the eligibility requirement for disability insurance benefits under which an individual must have 20 quarters of Social Security coverage in the 40 quarters preceding a disability shall not be applicable in the case of a disabled individual suffering from a covered terminal disease. S.1865: to provide for mandatory availability of life insurance that does not preclude future lawful travel, and for other purposes. S.2795:to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible. S.2818: to amend the Employee Retirement Income Security Act of 1974 and the Public Health Service Act to provide for enhanced health insurance marketplace pooling and relating market rating. S.3068: to require equitable coverage of prescription contraceptive drugs and devices, and contraceptive services under health plans. S.3115: to amend title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to prohibit preexisting condition exclusions for children in group health plans and health insurance coverage in the group and individual markets.

Client expense: $515,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

Mental Health Parity, S. 558, Benefit Mandates Association Health Plans/Small Business Health Plans Tax Credits, Health Savings Accounts, Flexible Spending Accounts HSA Improvement/Expansion Act- H.R. 3234 National Health Information Incentive Act- H.R. 1952 Uniform application of ERISA mandates Workforce Training SHOP Act- S. 2795, H.R. 6210 CHOICE Act- H.R. 6582 Health Care Reform

Client expense: $1,120,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Treasury, Dept of, White House Office

H.R. 6201 Student to School Nurse Ratio Improvement Act H.R. 6210 Small Business Health Options Program Act H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 6898 Health-e Information Technology Act H.R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act S. 2795 The Small Business Health Options Program Act Development of health care reform legislation Development of legislation to establish a Medicare value-based purchasing program for hospitals State Children's Health Insurance Program reauthorization

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD-10 Implementation: HR 1368 "Personalized Health Information Act of 2007," S 1783 and S 1693 "Wired for Health Care Quality Act," HR 3800 "Promoting Health Information Technology Act;" HR 2406 "Healthcare Information Technology Enterprise Integration Act;" HR 6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer-Based Healthcare System; Small Group Market/ Small Business Healthcare; Uninsured; Health Disparities; Connectors/Virtual Connectors; S 1019 "Health Care Choice Act of 2007," S334 and HR 3163 "Healthy Americans Act," S 2795 "Small Business Health Options Program Act of 2008" Mental Health Parity: S3712 "A Bill to make a technical correction in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" Comparative Effectiveness Funding: HR 3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only, HR 2184 "Enhanced Health Care Value for All Act," S3408 "Comparative Effectiveness Research Act of 2008" SCHIP; HR 976 and HR 3963 "SCHIP Extension Bill"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Supported the Small Business Health Options Program Act of 2008 (SHOP) (S. 2795) and the Small Business Health Plans Act (S. 2818) as a feasible mechanism for providing health insurance to the nation's small business employees and employers.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Expansion of Small Business Health Insurance Coverage: H.R. 6210 - Small Business Health Options Program Act of 2008 H.R. 5918 / S.2795 - Small Business Health Options Program Act of 2008 Expansion of Small Business Health Insurance Coverage (cont'd): H.R. 6582 - Small Business CHOICE Act of 2008 H.R. 6444 - Healthy Americans Act H.R. 2132 - Small Business Health Plans Act of 2007 H.R. 4460 - Health Care Choice Act of 2007 S. 2477 - Health Care Choice Act of 2007 S. 2818 - The Small Business Health Plans Act of 2008 H.R. 1200 - American Health Security Act of 2007 S. 334 - Healthy Americans Act S. 685 - Reform Health Care Now Act S. 158 - Access to Affordable Health Care Act H.R. 853 - Wellness & Prevention Act of 2007 H.R. 676 - United States Health Insurance Act (or the Expanded & Improved Medical for All Act) H.R. 241 - Small Business Health Fairness Act of 2007 S. 733 - Promoting Health Care Purchasing Cooperatives Act

Client expense: $6,520,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Environmental Protection Agency (EPA), Farm Credit Administration, Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Treasury, Dept of, U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

Supported all provisions unless otherwise indicated: BOTH SENATE AND HOUSE: S. 2795, H.R. 6210, Small Business Health Options Program (SHOP) Act H.R. 1424, Emergency Economic Stabilization Act of 2008 - supported mental health parity provisions Supported all provisions unless otherwise indicated: SENATE ONLY: S. 1576, Minority Health Improvement and Health Disparity Elimination Act S. 2838, Fairness in Nursing Home Arbitration Act HOUSE ONLY: H.R. 3309, Voluntary State Discount Prescription Drug Plan Act of 2007 H.R. 6316, Climate MATTERS Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE