A bill 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. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007, provisions dealing with RHC reimbursement H.R. 2860 Health Care Access and Rural Equity Act of 2007, provisions dealing with RHC reimbursement S. 630 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 2159 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health cli H.R. 3162 Children's Health and Medicare Protection (CHAMP) Act of 2007, provisions relating to RHC reimbursement Medicare, Medicaid, SCHIP Extension Act of 2007, provisions related to RHC reimbursement S. 1693 Wired for Health Care Quality Act, provisions related to infrastructure development for rural providers H.R. 630 Rural Health Services Preservation Act, provisions related to RHC reimbursement H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, raising the rural health clinics per visit cap S. 901 Health Centers Renewal Act of 2007, provisions dealing with Rural Health Clinics H.R. 1343 Health Centers Renewal Act of 2007 provisions dealing with Rural Health Clinics S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, provisions dealing with delay of RHC rules S. 3367 Legislation to modify the RHC statute to make certification timetables consistent

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

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

Medikids Health Insurance Act-S.2322/H.R.2357; (PPS Resolution-HCR 231/SCR65); Helping Fill the Medicare Rx Gap Act of 2007-S.1103; The Medicare Access to Community Health Centers Act-H.R. 2897/S.2188; Childrens Health Insurance Program Reauthorization Act-S. 1893/H.R.976; Childrens Health and Medicare Protection Act-H.R. 3162; CHIP Reauthorization Act-S. 1224; Childrens Dental Health Improvement Act-H.R. 1781; Deamontes Law H.R. 2371; Childrens Health First Act-H.R.1535; Legal Immigrant Childrens Health Improvement Act-H.R.1308/S.764; Medicare, Medicaid, SCHIP Extension Act-S.2499; Medicare Improvement for Patients and Providers Act of 2008-S.3101; Preserving Access to Medicare Act of 2008-S.3118; Medicare Improvements for Patients and Providers Act of 2008-H.R.6331; Medicare Telehealth Enhancement Act of 2008-H.R.6313; The Protecting Records Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008-H.R.6357; The Health Information Technology Act of 2008-H.R.6898; Preserving Access to Healthcare Act of 2008-S.3556; Regarding Rural Health Clinics-S.3367.

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

S 3656: Preserving Access to Healthcare (PATH) Act of 2008, sections relating to rural health clinics, hospices, and hospitals. HR 6873: Medicare Hospice Protection Act of 2008, entire bill. S 3484: Hospice Protection Act of 2008, entire bill. HR 1424: Emergency Economic Stabilization Act of 2008, Title V, Subsection B, mental health parity. S 3367: Rural Health Clinic bill to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program, entire bill. HR 1343: Health Care Safety Net Act of 2008, section 7: Revision of Timeframe for RHCs; section 3: National Health Service Corps. HR 6966: Safeguarding our Hospitals' Futures Act of 2008, entire bill. S 3582: Safeguarding our Hospitals' Futures Act of 2008, entire bill. HR 6912: Rural Hospital Assistance Act of 2008, entire bill. S 3300: Rural Hospital Assistance Act of 2008, entire bill. HR 6652: Nurses' Higher Education and Loan Repayment Act of 2008, entire bill. HR 6331: Medicare Improvements for Patients and Providers Act of 2008, section 131 involving the physician-fix; section 122 involving rebasing for sole community hospitals, section 148, clarification of payment for clinical laboratory tests furnished by CAH. S 3101: Medicare Improvements for Patients and Providers Act of 2008, section 131 involving the physician-fix; section 122 involving rebasing for sole community hospitals, section 149, clarification of payment for clinical laboratory tests furnished by CAH. HR 6699: Health Security for All Americans Act of 2008, section 105 involving improvements to Medicare-dependent hospital program; section 106 involving payment adjustment for low-volume hospitals. HR 2583: Physician Workforce Enhancement Act of 2008, provisions relating to hospitals. HR 7067: Quality FIRST Act of 2008, provisions relating to hospitals and value-based purchasing. Other issues: Physician self-referral to physician-owned hospitals. Reject cuts in the indirect medical education adjustment for teaching hospitals' capital costs: Schumer,Specter,Clinton Senate letter and Marshall,King House letter. Critical Access Hospital contract/employment issue involving 485.635 CoP: Provision of services (CAH). Guidance for clinical integration programs. Medicaid DSH letter: Rep. John Sullivan letter requesting funding increases and to update the definition to Medicaid's Low DSH states. Value-based purchasing. CMS proposed rule for the FY2009 inpatient PPS: proposals relating to hospitals. CMS Recovery Audit Contractors program.

Criteria for maintaining RHC status Definition of rural and underserved areas H.R. 3162 - Children's Health and Medicare Protection (CHAMP) Act of 2007, provisions relating to physician owned hospitals S. 2499 - Medicare, Medicaid SCHIP Extension Act of 2007, provisions relating to physician owned hospitals All legislation proposing to limit physician ownership in hospitals Legislation dealing with definition of "rural" for purposes of participation in the Medicare program H.R. 6124, Food, Conservation, and Energy Act of 2008, provision relating to physician owned hospitals H.R. 1424, Paul Wellstone Mental Health and Addiction Equity Act of 2008, provisions relating to physician ownership of hospitals. H.R. 2642, the Supplemental Appropriations Act, 2008, provision relating to physician ownership of hospitals H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, provisions relating to rural health clinics and the definition of "rural". S. 3367 Legislation to modify the RHc statute to make certification timetables consistent S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, provisions modifying RHC statute. Proposed Rules making changes in the RHC rules and regulations

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

S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007, provisions dealing with RHC reimbursement H.R. 2860 Health Care Access and Rural Equity Act of 2007, provisions dealing with RHC reimbursement S. 630 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 2159 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health cli H.R. 3162 Children's Health and Medicare Protection (CHAMP) Act of 2007, provisions relating to RHC reimbursement Medicare, Medicaid, SCHIP Extension Act of 2007, provisions related to RHC reimbursement S. 1693 Wired for Health Care Quality Act, provisions related to infrastructure development for rural providers H.R. 630 Rural Health Services Preservation Act, provisions related to RHC reimbursement H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, raising the rural health clinics per visit cap S. 901 Health Centers Renewal Act of 2007, provisions dealing with Rural Health Clinics H.R. 1343 Health Centers Renewal Act of 2007 provisions dealing with Rural Health Clinics S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, provisions dealing with delay of RHC rules S. 3367 Legislation to modify the RHC statute to make certification timetables consistent

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