Economic Recovery in Health Care Act of 2008

HR 5613 - Protecting the Medicaid Safety Net Act of 2008 HR 5268 - To provide for a temporary increase of the Federal Medical assistance percentage under the Medicaid Program, and for other purposes S 2819 - Economic Recovery in Health Care Act of 2008 HR 2642 - Military Construction and Veterans Affairs Appropriations Act, 2008 HR 6331- Medicare Improvements for Paients and Providers Act of 2008 HR 6174 - Equality in Medicare Advantag Payment Act of 2008

Client expense: $311,546 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.882 - Access to Emergency Medical Services Act of 2007 H.R.1093 - Resident Physician Shortage Reduction Act of 2007 H.R.1424 - Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.2050 - Medicaid Emergency Psychiatric Care Act of 2007 H.R.2164 Medicare Ambulance Payment Extension Act H.R.2749 Voluntary Medicare Quality Reporting Act H.R.3533 Public and Teaching Hospital Preservation Act H.R.4736 To amend Part B of Title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing H.R.5445 To amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physicians services through December 31, 2009 H.R.5613 Protecting the Medicaid Safety Net Act of 2008 S.588 Resident Physician Shortage Reduction Act of 2007 S.1003 Access to Emergency Medical Services Act of 2007 S.1310 Medicare Ambulance Payment Extension Act S.1408 Health Information Technology Act of 2007 S.1519 Voluntary Medicare Quality Reporting Act S.1947 Continuing the Advancement of Quality Improvement Act of 2007 S.2406 Medicaid Emergency Psychiatric Care Act of 2007 S.2729 Ensuring the Future Physician Workforce Act of 2008 S.2785 Save Medicare Act of 2008 S.2819 Economic Recovery in Health Care Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6331/S. 3101 The Medicare Improvements for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. H.R. 1424 Paul Wellstone Mental Health Parity and Addiction Act, Section 106 in House Bill. S. 558 Mental Health Parity Act 2007, Entire Bill. H.R. 5998 Medicaid SCHIP Directive, Entire Bill. H.R. 6357 To amend the Public Health Service Act. S. 2819 Economical Recovery in Health Care Act of 2008, Entire Bill. H.R. 4105 RAC, Entire Bill. H.R. 5924 Emergency Nursing Supply Relief Act, Entire Bill. H.R. 5882 To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future, Entire Bill. H.R. 6163 Medicare Telehealth Enhancement Act of 2008, Entire Bill. H.R. 6966 Safeguarding Our Hospitals' Futures Act of 2008, Entire Bill. H.R. 7110 Job Creation and Unemployment Relief Act of 2008, Title III-FMAP. H.R. 7067 Quality FIRST, Entire Bill. H.R. 7241/S. 3656 Preserving Access to Healthcare Act of 2008, Entire Bill. H.R. 5613 Protect Medicaid Safety Net, Entire Bill. H.R. 5942 National Trauma Center Stabilization Act, Entire Bill. S. 3101 The Medicare Improvements for Patients and Providers Act, Rural Hospital provisions. H.R. 4355/S. 2460 To impose moratorium on certain Medicaid payment restrictions, Entire Bill. H.R. 3533 Public and Teaching Hospital Preservation Act, Entire Bill. H.R. 1174 Health Hospitals Act of 2007, Entire Bill. S. 1842/H.R. 2122 Safe Nursing and Patient Care Act of 2007, Entire Bill. S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, Entire Bill. H.R. 7241 Preserving Access to Heatlhcare (PATH) Act of 2008, Entire Bill. H.R. 7067 Quality First Act, Entire Bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5613 Protecting the Medicaid Safety Net S. 2578 S. 2819 Economic Recovery to Health Care Act CMS Mediciad regulations legistive fix

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 4355/S 2460, To impose moratorium on certain Medicaid payment restrictions, Entire Bill. HR 3533, Public and Teaching Hospital Preservation Act, Entire Bill. HR 5613, Protecting the Medicaid Safety Net Act of 2008, Entire Bill. S 2819, Economical Recovery in Health Care Act of 2008, Entire Bill. HR 4105, Medicare Recovery in Audit Contractor Program Moratorium Act of 2007, Entire Bill. HR 1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007, Section 106 Limitation on Physician Ownership of Hospital. HR 1174, Health Hospitals Act of 2007, Entire Bill. S 1842/HR 2122, Safe Nursing and Patient Care Act of 2007, Entire Bill. Social Security Income Days-Disporportionate Share Hospital Payments, Miscalculation of SSI Days by CMS.

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

S.3604, "National Park Centurial Fund Act," Title III, relating to a temporary increase in Medicaid FMAP. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, all provisions. H.R. 3162, "Children's Health and Medicare Protection Act," provisions relating to the State Children's Health Insurance Program and Medicaid. H.R. 1535, S.895, "Children's Health First Act," all provisions. H.R. 2357, "MediKids Health Insurance Act of 2007," all provisions. H.R. 2147, S.1364, "Healthy Kids Act of 2007," all provisions. S. 2819, Economic Recovery in Health Care Act of 2008, all provisions. Issues relating to the collection of Healthcare Effectiveness Data and Information Set measures from all state Medicaid programs. Issues relating to implementation of Section 6004 of the Deficit Reduction Act of 2005, which allows childrens hospitals to participate in the 340B Drug Pricing Program. S.J. Res. 44, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States code, of the rule set forth as requirements contained in the August 17, 2007, letter to State Health Officials from the Director of the Center for Medicaid and State Operations in the Center For Medicare and Medicaid Services and that State Health Official Letter 08-003, dated May 7, 2008, from such Center. H.R. 7219, "Protecting Hospital Outpatient and Community Clinic Services Act," all provisions. H.R. 7110 Making supplemental appropriations for job creation and preservation, infrastructure investment and economic and energy assistance for the fiscal year ending September 30, 2009 and for other purposes, Title III, temporary increase in Medicaid matching rate. H.R. 7241, Preserving Access to Healthcare (PATH) Act of 2008. Sec. 3, relating to Medicaid Outpatient Hospital Services.

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

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

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

Support HR 5613, Medicaid Safety Net Act Support S 2819, Economic Recovery in Health Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program; H.R. 6912 and S. 3300 Rural Hospital Assistance Act of 2008, to amend title XVIII of the Social Security Act to provide for temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals and to provide for the use of the non-wage adjusted PPS rate under the Medicare-dependent hospital (MDH) program, and for other purposes; S. 3327 Empowered at Home Act of 2008, to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; H.R. 6394 Border Health Care Relief Act of 2008, to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend Federal reimbursement of emergency health services furnished to undocumented aliens, and for other purposes; S. 3367, to amend title XVIII of the Social Security Act to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program; S. 3656 and H.R. 7241 Preserving Access to Healthcare (PATH) Act of 2008, a bill to preserve access to healthcare under the Medicare and Medicaid programs. The sections related to the Medicare indirect medical education adjustment factor and the delay in implementation of Medicaid outpatient hospital services regulation; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H. R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008, to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; H. R. 6966 and S. 3582 Safeguarding Our Hospitals' Futures Act of 2008, all provisions to require continued application of budget neutrality on a national basis in calculation of the Medicare urban hospital wage floor.

Client expense: $4,910,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA)

S 3689 -Economic Recovery Act of 2008 HR 6770, Economic Stimulus bill, Medicaid/FMAP increase, investments for state aid, public housing, other public services S 2819, S 3604, HR 5268, HR 7110 -Aid to the States, Medicaid Medicare Prescription Drug Program

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 2819, S 3604, HR 5268, HR 7110 -Economic Stimulus Job Creation and Economic Relief Act, Aid to the States, FMAP/ Medicaid, investment provisions for state aid, public housing and other public services, S 3689 -Economic Recovery Act of 2008 Economic Stimulus bill -child support enforcement restoration, Medicaid/FMAP, Social Services Block Grant HR 6770 -State and Local Economic Stimulus Act HR 1424 -Emergency Economic Stabilization Act S 803, HR 1386 -child support enforcement restoration HR 7321, HR 7005 -Auto Industry Loan Assistance HR 17, S 380 -Secure Rural Schools Act Financial Institutions Rescue

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1424/S.558 - Paul Wellstone Mental Health Parity & Addiction Act - Sect. 106 of House bill H.R. 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 - Entire bill H.R. 5613 - Protecting the Medicaid Safety Net Act of 2008 - Entire bill S. 2819 Economical Recovery in Health Care Act of 2008 - Entire bill H.R. 5882 - To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future - Entire Bill H.R. 5924 - Emergency Nurse Supply Relief Act of 2008 - Entire bill H.R. 5942 - National Trauma Center Stabilization Act of 2008 - Entire bill H.R. 5998 - Protecting Children's Health Coverage Act of 2008 - Medicaid SCHIP Directive, Entire bill H.R. 6163 - Medicare Telehealth Enhancement Act - Entire bill. H.R. 6357 - PRO(TECH)T Act of 2008 - To amend Public Health - Entire bill H.R. 6331 - Medicare Improvements for Patients and Providers Act - Sections 121-125, 145, 205 H.R. 6898 - Health-e Information Technology Act of 2008 - Entire bill H.R. 6966 - Safeguarding Our Hospitals' Futures Act of 2008 - Entire bill H.R. 7067 - Quality FIRST Act of 2008 - Entire bill H.R. 7110 - Job Creation and Unemployement Relief Act of 2008 - Title III, Medicaid FMAP H.R. 7241 - Preserving Access to Healthcare (PATH) Act of 2008 - Entire bill S. 3656 - Preserving Access to Healthcare (PATH) Act of 2008 - Entire bill S. 3101 - Medicare Improvements for Patients and Providers Act - Rural Hospital Provisions

Client expense: $168,500 · Firm income: Not reported

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

Supported all provisions unless otherwise indicated: BOTH SENATE AND HOUSE S.2620, H.R. 5268, To provide a temporary increase of the Federal medical assistance percentage (FMAP) under the Medicaid program and for other purposes Supported all provisions unless otherwise indicated: BOTH SENATE AND HOUSE: S. 3101, H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 2102, H.R. 154, Ending the Medicare Disability Waiting Period Act of 2007 S. 3560, QI [Qualified Individuals] Program Supplemental Funding Act of 2008 H.R. 7110, Job Creation and Unemployment Relief Act of 2008 - supported provisions related to temporary FMAP increase SENATE ONLY: S. 2586, State Fiscal Relief Act of 2008, provisions relating to providing a temporary FMAP increase, freezing the Medicaid regulations and for other purposes S. 2819, Economic Recovery in Health Care Act of 2008 HOUSE ONLY: H.R. 5613, Protecting the Medicaid Safety Net Act of 2008 H.R. 6684, Medicare Prescription Drug Cost Equalization Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

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

Client expense: Not reported · Firm income: Not reported

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

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

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

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

Medicare reimbursement Iowa hospitals; CMS interagency transfers; IME issues; Medicaid reimbursement issues; DHS; GME (dental and others); Medicare and Medicaid reimbursement issues at relate to academic teaching hospitals; CMS rules as they relate to physician and hospital payments, 340 B Drug Pricing Program; H.R. 5613 Protecting the Medical Safety Act of 2008 H.R. 2642 FY08 Supplemental Appropriations; S. 2819 Economic Recovery in Health Care Act of 2008

Client expense: $110,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT)

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

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, White House Office

Ban on Self-Referral to Physician-Owned Hospitals Provision that will prospectively ban the practice of physicians referring patients to hospitals that are owned by the physician. S. 2819 Economic Recovery in Health Care Act Legislation to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief. HR 5613 - Protecting the Medicaid Safety Net Act of 2008 To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009. Rural Medicare DSH Equity Providing for equity in Medicare Disproportionate Share Hospital (DSH) payments between rural and urban hospitals. Section 1011 Funding - Section 1011, Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens, provides $250 million per year for fiscal years (FY) 2005-2008 for payments to eligible providers for emergency health services provided to undocumented aliens and other specified aliens. Value based purchasing Center for Medicare and Medicaid Services (CMS) initiative to more closely tie payments to providers with the quality of care provided. HR6331 Medicare Improvements for Patients and Providers - To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes.

Client expense: $660,000 · Firm income: Not reported

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

H.R. 1809, Medicare Independent Living Ct of 2007, provisions that assist persons with disabilities. P.L. 109-171, Choice Act, Direct Support Profefssioinals Fairness andSecurity Act (H.R. 1279). S. 1799 and H.R. 1621, Community Choice Act, provisions providing independence for individuals with disabilities. H.R. 1279, Direct Support Professional Fairness and Security Act of 2007, provisions dealing with direct support workers for persons with disabilities. P.L. 109-171, implementation of the Deficit ReductionAct, provisions dealing with TANF and Medicaid. S. 2499, Medicare, Medicaid and SCHIP Extension Act of 2007. Legislation not yet introduced to amend the Deficit Reduction Act of 2005 to improve usefullness of the new section 1915(i) Home and Community-Based Services Option. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, sections pertaining to moratoria on Centers for Medicare and Medicaid Services rehabilitation option, case management and school based services/transportation regulations. S. 2819, Economic Recovery in Health Care Act of 2008, same as above as well as provision to impose a moratoria on SCHIP directive and provisions to provide state fiscal relief. S. 2578 and H.R. 5173, legisation to impose a one year moratorium on the CMS case management rule. H.R. 4355, moratorium on rehabilitation option and school-based transportation rule. S.Con.Res. 70 and H.Con.Res. 312, FY 2009 Budget Resolutions, provisions dealing with Medicaid reserve funds.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Election Assistance Commission (EAC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H 976/S 1893: State Children's Health Insurance Program; HR 3963: Children's Health Insurance Program Reauthorization Act of 2007; Medicare and Medicaid reform; Medicare competitive bidding; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003; HR 1017/S 578 Protecting Children's Health in Schools Act; Federal Medical Assistance Percentage legislation; HR 1333/S 647: Medicare Patient Access to Physical Therapists Act of 2005 HR 748/S 450: Medicare Access to Rehabilitation Services Act; H. Con. Res. 99/S. Con. Res. 21 budget legislation; HR 1621/S 799: Community Choice Act of 2007; HR 5613: Protecting the Medicaid Safety Net Act of 2008; HR 6331/S 3101: Medicare Improvements for Patients and Providers Act of 2008; HR 2642: Military Construction and Veterans Affairs Appropriation Act of 2008; S 2819: Economic Recovery in Health Care Act.

Client expense: $78,906 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage program - Proposed legislation concerning this issue. Medicare/Medicaid issues - HR 4, Medicare Prescription Drug Price Negotiation Act of 2007; S 3, Medicare Prescription Drug Price Negotiation Act of 2007; S 1102, Part D Equity for Low-Income Seniors Act of 2007; S 1103, Helping Fill the Medicare Rx Gap Act of 2007; S 1107, Home and Community Services Copayment Equity Act of 2007; S 1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007; HR 2945, Medicare Advantage Truth in Advertising Act of 2007; S 799, Community Choice Act of 2007; S 1544, Medicare Quality Enhancement Act of 2007; S 1507, Access to Medicare Data Act of 2007; S 1827, Pharmacist Access and Recognition in Medicare (PhARM) Act of 2007; HR 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007; HR 3061, Medicare Part D Drug Class Protection Act of 2007; HR 3162, Children's Health and Medicare Protection Act of 2007; HR 976, Children's Health Insurance Program Reauthorization Act of 2007; S 1893, Children's Health Insurance Program Reauthorization Act of 2007; S 1954, Pharmacy Access Improvement (PhAIm) Act of 2007; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; S 2219, Medicare Prescription Drug Savings and Choice Act of 2007; HR 3932, Medicare Prescription Drug Savings and Choice Act of 2007; S 2408, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; HR 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; S 1200, Indian Health Care Improvement Act Amendments of 2008; HR 5480, Medicare Funding Warning Response Act of 2008; S 2662, Medicare Funding Warning Response Act of 2008; HR 5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; HR 6388, Government Accountability Office Improvement Act of 2008; HR 5998, Fair and Justifiable Credit Card Interest Rate Act of 2008; S 2819, Economic Recovery in Health Care Act of 2008; HR 6359, Medicare Beneficiary Protection Act of 2008; HR 6365, Medicare Special Needs Plans Extension and Amendments Act of 2008; HR 5613, Protecting the Medicaid Safety Net Act of 2008; S 2620, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid program; HR 5683, Government Accountability Office Act of 2008; HR 7110, Job Creation and Unemployment Relief Act of 2008; S 3560, QI Program Supplemental Funding Act of 2008; HR 7077, QI Program Supplemental Funding Act of 2008; S 3604, Emergency Supplemental; HR 7197, To amend part C of title XVIII of the Social Security Act to limit increases in Medicare Advantage payment rates; S 3656, Preserving Access to Healthcare (PATH) Act of 2008; S 3689, Economic Stimulus; S 3710, Medicare Early Access Act of 2008; S 3101, Medicare Improvements for Patients and Providers Act of 2008.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1809, Medicare Independent Living Act of 2007, provisions that assist persons with disabilities. S. 1799 and H.R. 1621, Community Choice Act, provisions providing independence for individuals with disabilities. P.L. 109-171, implementation of the Deficit ReductionAct, provisions dealing with Medicaid. S. 2499, Medicare, Medicaid and SCHIP Extension Act of 2007. P.L. 110-252, Protecting the Medicaid Safety Net Act of 2008, sections pertaining to moratoria on Centers for Medicare and Medicaid Services rehabilitation option, case management and school based services/transportation regulations. H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008. S. 2819, Economic Recovery in Health Care Act of 2008, same as above as well as provision to impose a moratoria on SCHIP directive and provisions to provide state fiscal relief. S.Con.Res. 70 and H.Con.Res. 312, FY 2009 Budget Resolutions, provisions dealing with Medicaid reserve funds. Legislation dealing with direct support worker issues. Implementation of Medicaid Section 1917 (d) regarding trusts and transfer of asset rules. S.3327, the Empowered at Home Act of 2008 to amend the Medicaid Section 1915 (i) Home and Community Based Services Option. Efforts to elminate the 24-month waiting period for Medicare. Implementation of the Olmstead decision regarding community integration. Health Care Reform. Federal Medical Assistance Percentage (FMAP increase.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Election Assistance Commission (EAC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

H.R. 6331/S. 3101 The Medicare Improvements for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. H.R. 1424 Paul Wellstone Mental Health Parity and Addiction Act, Section 106 in House Bill. S. 558 Mental Health Parity Act 2007, Entire Bill. H.R. 5998 Medicaid SCHIP Directive, Entire Bill. H.R. 6357 To amend the Public Health Service Act. S. 2819 Economical Recovery in Health Care Act of 2008, Entire Bill. H.R. 4105 RAC, Entire Bill. H.R. 5924 Emergency Nursing Supply Relief Act, Entire Bill. H.R. 5882 To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future, Entire Bill. H.R. 6163 Medicare Telehealth Enhancement Act of 2008, Entire Bill. H.R. 6966 Safeguarding Our Hospitals' Futures Act of 2008, Entire Bill. H.R. 7110 Job Creation and Unemployment Relief Act of 2008, Title III-FMAP. H.R. 7067 Quality FIRST, Entire Bill. H.R. 7241/S. 3656 Preserving Access to Healthcare Act of 2008, Entire Bill. H.R. 5613 Protect Medicaid Safety Net, Entire Bill. H.R. 5942 National Trauma Center Stabilization Act, Entire Bill. S. 3101 The Medicare Improvements for Patients and Providers Act, Rural Hospital provisions. H.R. 4355/S. 2460 To impose moratorium on certain Medicaid payment restrictions, Entire Bill. H.R. 3533 Public and Teaching Hospital Preservation Act, Entire Bill. H.R. 1174 Health Hospitals Act of 2007, Entire Bill. S. 1842/H.R. 2122 Safe Nursing and Patient Care Act of 2007, Entire Bill. S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, Entire Bill. H.R. 7241 Preserving Access to Heatlhcare (PATH) Act of 2008, Entire Bill. H.R. 7067 Quality First Act, Entire Bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R. 4105 - To impose a moratorium on the use of recovery audit contrators under the Medicare Integrity Program. H.R. 976 - An act to amend title XXI of the Social Sercurity Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R. 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold to determine whether a hospital or unit is an impatient rehabilitation facility. H.R. 562 - To amend title XVIII of teh Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R. 3162 - To amend titles XVII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R. 1621 - To amnd title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R. 1536 - To amend part D of title XVII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R. 4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009, and for other purposes. H.R.6331 - To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. H.R.5480 - To respond to a Medicare funding warning. S.2662 - A bill to respond to a medicare funding warning. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S. 2819 - A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn, and for other purposes. S. 3101 - A bill to amend titles XVII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care sub rural areas, including pharmacy access, and for other purposes. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S. 2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and firect care workers dedicated to providing quality care to the growing population of older Americans. S. 2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S. 2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under teh Medicare program for beneficiaries residing in rural areas. H.R.5480 - To respond to a Medicare funding warning.

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

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

1. Medicare Physician Fee Schedule - AAGP urges Congress to replace the current Medicare reimbursement formula with one that more accurately reflects the volume and intensity of services furnished to Medicare beneficiaries and to take action to avert future cuts in Medicare payments to physicians and other health care providers. 2. S. 2578/H.R. 5173 - Support provisions to impose a moratorium on newly imposed target case management Medicaid regulations, which would unduly restrict the ability of Medicaid beneficiaries to access needed care, including community-based mental health services. 3. S. 2819, "Economic Recovery in Health Care Act" - Support all provisions. The bill would delay Medicaid regulations on targeted case management and other Medicaid rules.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid IGT Rule HR 5613 Protecting the Medicaid Safety-Net Act of 2008 S2819 Economic Recovery in Healthcare Act of 2008 War Supplemental HR 2642

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Citizenship documentation legislation (S. 909) Medikids Health Insurance Act (H.R. 2357) Children's Health First Act (S.895, H.R. 1535) Children's Express Lane to Health Coverage Act (S. 1214) Healthy Schools Act (S. 1669) Healthy Kids Act (H.R. 1364, H.R.. 2147) Protecting the Medicaid Safety Net Act (H.R. 5613) Economic Recovery in Healthcare Act (S. 2819)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2860, The Health Care Access and Rural Equity Act of 2007 -- sections 305 and 309 S. 321, Fostering Independence Through Technology Act of 2007 -- All sections S. 1605, Craig Thomas Rural Hospital and Provider Equity Act of 2007 -- sections 14 and 18 S. 1678, Home Health Care Planning Improvement Act of 2007 -- All sections S. 2181/H.R. 3865, The Fair Home Health Care Act -- All sections H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 -- effort to include home health rural add-on as amendment S. 3101, Medicare Improvements for Patients and Providers Act of 2008 --effort to include home health rural add-on as amendment S. 3118, Preserving Access to Medicare Act of 2008 -- section 112 H.R. 5613/S. 2819, Protecting the Medicaid Safety Net Act of 2008 -- All sections H.R. 2642, Supplemental Appropriations Act, 2008 -- Title VII Medicaid H.R. 6163, Medicare Telehealth Enhancement Act of 2008 -- sections 104, 105, and 106 S. 3613/H.R. 7114, The Independence at Home Act -- All sections S. 1340, The Geriatric Assessment and Chronic Care Coordination Act of 2007 -- All sections S. 3484/H.R. 6873 -- The Medicare Hospice Protection Act -- All sections S. 1628/H.R. 6826 -- The Home Health Care Planning Improvement Act -- All sections S. 1577/H.R. 3078 -- The Patient Safety and Abuse Prevention Act -- All sections

Client expense: $170,000 · Firm income: Not reported

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

S.1693 -- The Wired for Health Care Quality Act H.R. 2606 - To Amend Section 340B of the Public Health Service Act H.R. 5605 - Physicians Payments Sunshine Act H.R. 3533 - Public and Teaching Hospital Prevention Act Healthcare Group Purchasing Value-Based Medicare Purchasing Healthcare Acquired Infections Inpatient Prospective Payment System Health Information Technology IVIG Average Sales Price for Part B Drugs Medicare, Medicaid and SCHIP S. 2313 - Strategies to Address Antimicrobial Resistance Act H.R. 3697 - Strategies to Address Antimicrobial Resistance Act Unique Device Identification H.R. 5613 - Protecting the Medicaid Safety Net of 2008 S. 2819 - Economic Recovery in Health Care Act of 2008 S. 2029 - Physician Payments Sunshine Act of 2007 S. 2460 - Extends Medicaid Moratorium H.R. 5442 - Trust in Health Information Act of 2008 S. 1814 - Health Information Privacy and Security Act H.R. 7067 - Quality First Act H.R. 6898 - Health-e Information Technology Act of 2008 S. 3656 - Preserving Access to Healthcare Act Physician Self-Referral H.R. 6331 - Medicare Improvements for Patients and Providers Act H. R. 6357 - Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 1424 - Emergency Economic Stabilization Act of 2008 Medicaid Outpatient Graduate Medical Education

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE

State Children's Health Insurance Program (SCHIP) HR 3162/S.1893/HR 976 Veto Override Managed Care Reform Title VII, PHS act H.R. 2357/S. 2522 MediKids Appropriate Physician payment levels/systems Medical Records Confidentiality Deficit Reduction Act Children's Access to health insurance Immunizations WIC national Immunizations program (administration) The Start Healthy, Stay Healthy Act Medikids Health Insurance Act of 2007 Immunization Coding Issues Paul Wellstone Mental Health and Addiction Equity Act (HR 1424) Health Care Coverage Expansion and Quality Improvement Act Children's Access to Vision Improvement Act Pandemic Influenza Heath Information Technology/Electronic Health Records Emergency Medical Services for Children' Act Reauthorization Injury Prevention Child Health Care Crisis Relief Act s. 558 Mental Health Parity Act of 2007 Preemie Act Pediatrics Disaster Preparedness Education Begins at Home Act Child Maltreatment Foster Care and Adoption Native American Child Health Genetic Nondiscrimination Reauthorization of SCHIP S. 588 Resident Physician Shortage Reduction Act HR 3/S. 5 Stem Cell Research Enhancement Act HR 881 Mercury Free Vaccines Act HR 2184 Enhanced Health Care Value For All Act HR 2584 High Need Physician Workforce Incentives Act S. 1576 Minority Health Improvement and Health Disparity Elimination Act HR 1153 Parental Right to Decide Protection Act Access to Life-Saving Medicine Act Biologics Price Competition and Innovation Act of 2007 HR 1244/S. 600 School-Based Health Clinics Establishment Act HR 1198/S. 1069 Early Hearing and Detection and Intervention HR 1108/S. 625 Family Smoking Prevention and Tobacco Control Act FACT Act HR 2063/S.1232 Food Allergy and Anaphylaxis Act S. 877 Controlling the Abuse of Prescriptions Act of 2007 HR 4911 Human Growth Hormone Prescription Act HR 3411 Juvenile Crime Reduction Act HR 5178/S. 2451 First Step Forward Act HR 5178 Youth Reentry Improvement Act S. 2376 Medical Homes Act of 2007 HR 5501 Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008 HR 5629 Pathway for Biosimilars Act HR 5613 Protecting the Medicaid Safety Net Act of 2008 E-Meds Act S. 1551, Comprehensive TB Elimination Act S. 2456, Influenza Vaccine Security Act Garrett Lee Smith Memorial Act Child and Adolescent Mental Health Resilience Act of 2007 Arthritis Prevention control and care act of 2007 Underage Drinking Prevention Act of 2007 Patient and Pharmacy Protection Act of 2007 Non-prescription Drug Modernization Act of 2007 Global Pediatric HIV/AIDS Prevention and Treatment Act HR 5268 S.2819 S. 2685,Truth in Cigarette Labeling Act of 2008 H.R. 6393,Quit Smoking for Life Act of 2008 H.R. 1553/S. 911,Conquer Childhood Cancer Act of 2007 H.Res. 1216,Radiological Safety Resolution S. 3020,Food and Drug Administration Accountability and Trasparency Act H.R. 6901, Meth Free Families and Communities Act H.R. 5605/S. 2029, Physician Payments Sunshine Act S. 3155, Juvenile Justice adn Delinquency Prevention Reauthorization Act of 2008 H.S. 5524/S. 2982, Reconnecting Homelss Youth Act of 2008 H.R. 6680, Community AIDS and Hepatitis Prevention Act Americans with Disabilities Act Underage Drinking National center on Health Statistics

Client expense: $65,846 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Education, Dept of, Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Medicaid Budget/Funding/Reconciliation RBRVS Issues State Children's Health Insurance Program Funding SCHIP EQRO Standards Funding for Children's Hospital Graduate Medical Education Program (CHGME) Council on Graduate Medical Education (COGME) policies School-based transportation and administration regulations Medicaid Regulations-Targeted Case Management, Rehab, School-based Care HR 5612/S. 2819 Hospital Output, Transportation, IGT, School-Based Services FMAP August 17th Directive

Client expense: $65,846 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Education, Dept of, Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Economic Recovery in Health Care Act of 2008 (S. 2819) Medicare Recovery Audit Contractor Program Moratorium Act of 2007 (H.R. 4105) Preserving Access To Healthcare Act (PATH Act) (H.R. 7241/S. 3656) Public and Teaching Hospital Preservation Act (H.R. 3533) Section 1011 of the Medicare Modernization Act (MMA) (H.R. 6394) To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes. (H.R. 7110/S. 3604) 340B Program Improvement and Integrity Act of 2007 (H.R. 2606)

Client expense: $12,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support HR 5613, Medical Safety Net Act, Support moratoria of proposed rules to limit Medicaid funding to states. Support S 2819, Economic Recovery in Health Care Act, Support moratoria of proposed rules to limit Medicaid funding to states

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

Government targets: Army, Dept of (Corps of Engineers), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), SENATE

Support HR 5613, Medicaid Safety Net Act Support S 2819, Economic Recovery in Health Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1424/S.558 - Paul Wellstone Mental Health Parity & Addiction Act - Sect. 106 of House bill H.R. 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 - Entire bill H.R. 5613 - Protecting the Medicaid Safety Net Act of 2008 - Entire bill S. 2819 Economical Recovery in Health Care Act of 2008 - Entire bill H.R. 5882 - To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future - Entire Bill H.R. 5924 - Emergency Nurse Supply Relief Act of 2008 - Entire bill H.R. 5942 - National Trauma Center Stabilization Act of 2008 - Entire bill H.R. 5998 - Protecting Children's Health Coverage Act of 2008 - Medicaid SCHIP Directive, Entire bill H.R. 6163 - Medicare Telehealth Enhancement Act - Entire bill. H.R. 6357 - PRO(TECH)T Act of 2008 - To amend Public Health - Entire bill H.R. 6331 - Medicare Improvements for Patients and Providers Act - Sections 121-125, 145, 205 H.R. 6898 - Health-e Information Technology Act of 2008 - Entire bill H.R. 6966 - Safeguarding Our Hospitals' Futures Act of 2008 - Entire bill H.R. 7110 - Job Creation and Unemployment Relief Act of 2008 - Title III, Medicaid FMAP H.R. 7067 - Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008 - Entire bill S. 3101 - Medicare Improvements for Patients and Providers Act - Rural Hospital Provisions

Client expense: $157,000 · Firm income: Not reported

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

Medicare reimbursement Iowa hospitals; CMS interagency transfers; IME issues; Medicaid reimbursement issues; DHS; GME (dental and others); Medicare and Medicaid reimbursement issues at relate to academic teaching hospitals; CMS rules as they relate to physician and hospital payments, 340 B Drug Pricing Program; H.R. 5613 Protecting the Medical Safety Act of 2008 H.R. 2642 FY08 Supplemental Appropriations; S. 2819 Economic Recovery in Health Care Act of 2008

Client expense: $110,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT)

Drug Rebate Equalization Act (H.R. 3041/S. 1589) Enacting moratoria on Medicaid regulations issued by CMS since August 2007 (H.R. 5613; H.R. 2642; S. 2819) Reauthorizing the Medicare Advantage Special Needs Plan Program (H.R. 6331; H.R. 6212; S. 3101) Discussion of payment appropriate to the risk of the enrollee in Medicare Advantage Continuous Eligibility Issues for Medicaid Beneficiaries in Managed Care Support for increasing the Federal Medicaid Matching Rates as part of economic stimulus package

Client expense: $22,520 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program; H.R. 6912 and S. 3300 Rural Hospital Assistance Act of 2008, to amend title XVIII of the Social Security Act to provide for temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals and to provide for the use of the non-wage adjusted PPS rate under the Medicare-dependent hospital (MDH) program, and for other purposes; S. 3327 Empowered at Home Act of 2008, to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; H.R. 6394 Border Health Care Relief Act of 2008, to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend Federal reimbursement of emergency health services furnished to undocumented aliens, and for other purposes; S. 3367, to amend title XVIII of the Social Security Act to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program; S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, a bill to preserve access to healthcare under the Medicare and Medicaid programs. The sections related to the Medicare indirect medical education adjustment factor and the delay in implementation of Medicaid outpatient hospital services regulation; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H. R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008, to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; H. R. 6966 and S. 3582 Safeguarding Our Hospitals' Futures Act of 2008, all provisions to require continued application of budget neutrality on a national basis in calculation of the Medicare urban hospital wage floor.

Client expense: $3,950,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA)