Medicare Long-Term Care Hospital Improvement Act of 2007

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

support revisions to 75% Inpatient Rehabilitation Rule (HR 110/S. 543) support legislation regarding Hospital in Hospital regulations (HR 552/S.338) oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) (Mental Health Parity bill (HR 1424) and wherever attempted; support legislation reforming ASC reimbursement (HR 1823/S.2250)

Client expense: Not reported · Firm income: $33,000

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: $390,000 · Firm income: Not reported

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

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

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

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

H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.5613 - Protecting the Medicaid Safety Net Act of 2008, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

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

H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.5613 - Protecting the Medicaid Safety Net Act of 2008, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

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

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

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

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

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

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

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

support revisions to 75% Inpatient Rehabilitation Rule (HR 110/S. 543) support legislation regarding Hospital in Hospital regulations (HR 552/S.338) oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) (Mental Health Parity bill (HR 1424) and wherever attempted; support legislation reforming ASC reimbursement (HR 1823/S.2250)

Client expense: Not reported · Firm income: $33,000

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), 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 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. 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 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: $120,000 · Firm income: Not reported

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

HR 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. HR 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold d to determie whether a hospital or unit is an impatient rehabilitation facility. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.562 - 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. H.R.4105 - To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program. H.R.3162 - To amend titles XVIII, 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 amend 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 XVIII 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. 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.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 direct 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 the Medicare program for beneficiaries residing in rural areas. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009. 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. 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. S.3101 - A bill to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes.

Client expense: $380,000 · Firm income: Not reported

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

H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.5613 - Protecting the Medicaid Safety Net Act of 2008, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

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

H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.5613 - Protecting the Medicaid Safety Net Act of 2008, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

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

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

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

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

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

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

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

support revisions to 75% Inpatient Rehabilitation Rule (HR 110/S. 543);support legislation regarding Hospital in Hospital regulations (HR 552/S.338);oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) (Mental Health Parity bill (HR 1424), War Supplemental Appropriations Act (HR2642), and wherever attempted; support legislation reforming ASC reimbursement (HR 1823/S.2250)

Client expense: Not reported · Firm income: $33,000

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), 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 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions 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 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 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: $120,000 · Firm income: Not reported

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

HR 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. HR 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold d to determie whether a hospital or unit is an impatient rehabilitation facility. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.562 - 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. H.R.4105 - To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program. H.R.3162 - To amend titles XVIII, 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 amend 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 XVIII 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. 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.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 direct 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 the Medicare program for beneficiaries residing in rural areas. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009.

Client expense: $420,000 · Firm income: Not reported

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

H.R.3025 - To amend title XVIII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. H.R.562 - 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. H.R.4105 - To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program. H.R.3162 - To amend titles XVIII, 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 amend 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 XVIII 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. 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.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 direct 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 the Medicare program for beneficiaries residing in rural areas. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes.

Client expense: $420,000 · Firm income: Not reported

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

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

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

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

H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.5613 - Protecting the Medicaid Safety Net Act of 2008, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.5613 - Protecting the Medicaid Safety Net Act of 2008, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

support revisions to 75% Inpatient Rehabilitation Rule (HR 110/S. 543) support legislation regarding Hospital in Hospital regulations (HR 552/S.338) oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) (Mental Health Parity bill (HR 1424) and wherever attempted; support legislation reforming ASC reimbursement (HR 1823/S.2250)

Client expense: Not reported · Firm income: $33,000

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Medicare Long-Term Care Patient Safety and Improvement Act of 2007 (HR 3057, S.1958) Medicare Long-Term Care Hospital Improvement Act (HR 562, S.338) Preserving Patient Access to Inpatient Rehabilitation Hospital Act of 2007 (HR 1459, S.543) Medicare Quality Enhancement Act of 2007 (HR 3370, S.1544)

Client expense: $195,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Deficit Reduction Act SCHIP H.R.3162: Children’s Health and Medicare Protection Act of 2007. To amend titles XVIII, 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. S.2499: Medicare, Medicaid and SCHIP Extension Act of 2007. H.R.562: Medicare Long-Term Care Hospital Improvement Act of 2007. 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. H.R.1459: To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. H.R.3162: Children’s Health and Medicare Protection Act of 2007. To amend titles XVIII, 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. S.338: Medicare Long-Term Care Hospital Improvement Act of 2007. A bill to amend the 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.543: Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007. 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. GSE Reform Housing

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

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

HR 3025 HR 562 HR 1536 S 1107 S 2396 HR 1459 HR 4105 HR 4541 S 1893 HR 3162 HR 3162 HR 3963 S 338 HR 976 HR 1621 S 543 S 2499

Client expense: $881,000 · Firm income: Not reported

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

HR 3025 HR 562 HR 1536 S 1107 S 2396 HR 1459 HR 4105 HR 4541 S 1893 HR 3162 HR 3162 HR 3963 S 338 HR 976 HR 1621 S 543 S 2499

Client expense: $881,000 · Firm income: Not reported

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

* HR 3162, Children's Health and Medicare Protection Act of 2007; HR 976, Small Business Tax Relief Act of 2007; HR 562, Medicare Long-Term Care Hospital Improvement Act of 2007; S 338 Medicare Long-Term Care Hospital Improvement Act of 2007; S 1842, Safe Nursing and Patient Care Act of 2007; HR 2122, Safe Nursing and Patient Care Act of 2007; S 543, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007; S 2319, National Trauma Center Stabilization Act of 2007; HR 1459, To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility; S 1490, Federal Employees Electronic Personal Health Records Act of 2007; HR 1591, U.S. Troop Readiness, Veterans' Health, and Iraq Accountability Act, 2007; HR 2050, Medicaid Emergency Psychiatric Care Act of 2007; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; S 2499, Medicare, Medicaid, and SCHIP Extension Act of 2007; HR 2764, Department of State, Foreign Operations Appropriations for Fiscal Year 2008; HR 4355, To impose a moratorium on certain Medicaid payment restrictions; S 2460, To impose a moratorium on certain Medicaid payment restrictions. HR 1459, To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility; S 1490, Federal Employees Electronic Personal Health Records Act of 2007; HR 1591, U.S. Troop Readiness, Veterans' Health, and Iraq Accountability Act, 2007; HR 2050, Medicaid Emergency Psychiatric Care Act of 2007; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; S 2499, Medicare, Medicaid, and SCHIP Extension Act of 2007; HR 2764, Department of State, Foreign Operations Appropriations for Fiscal Year 2008; HR 4355, To impose a moratorium on certain Medicaid payment restrictions; S 2460, To impose a moratorium on certain Medicaid payment restrictions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

support revisions to 75% Inpatient Rehabilitation Rule (HR 1105/S. 543) support legislation regarding Hospital in Hospital regulations (HR 552/S. 338) oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) support legislation related to reforming Ambulatory Surgical Hospital reimbursement (HR 1823/S. 2250)

Client expense: Not reported · Firm income: $66,000

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

H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007 H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007 Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007 S.2221 - Transparency in Medical Device Pricing Act of 2007 S.2499 - Medicare, Medicaid, and SCHIP Extension Act of 2007 S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007 S.Con.Res.21 - Concurrent Resolution on the Budget for Fiscal Year 2008 Solutions for Patient Safety & Quality Improvement H.J.Res.20 - Revised Continuing Appropriations Resolution, 2007 H.R.2764 - Consolidated Appropriations Act, 2008 H.R.3162 - Children's Health and Medicare Protection Act of 2007 H.R.3963 – Children’s Health Insurance Program Reauthorization Act of 2007

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007 H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007 Hospital Charges Implementation of DRA (Deficit Reduction Act) Implementation of Medicare Prescription Drug and Modernization Act of 2003 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007 S.2221 - Transparency in Medical Device Pricing Act of 2007 S.2499 - Medicare, Medicaid, and SCHIP Extension Act of 2007 S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007 S.Con.Res.21 - Concurrent Resolution on the Budget for Fiscal Year 2008 Solutions for Patient Safety & Quality Improvement H.J.Res.20 - Revised Continuing Appropriations Resolution, 2007 H.R.2764 - Consolidated Appropriations Act, 2008 H.R.3162 - Children's Health and Medicare Protection Act of 2007 H.R.3963 – Children’s Health Insurance Program Reauthorization Act of 2007

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.3963 – Children’s Health Insurance Program Reauthorization Act of 2007 H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007 H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007 Implementation of DRA (Deficit Reduction Act) S.1893 - Children's Health Insurance Program Reauthorization Act of 2007 S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 S.2221 - Transparency in Medical Device Pricing Act of 2007 S.2499 - Medicare, Medicaid, and SCHIP Extension Act of 2007 S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007 S.Con.Res.21 - Concurrent Resolution on the Budget for Fiscal Year 2008 Annual Update for Inpatient Hospital Prospective Payment System H.J.Res.20 - Revised Continuing Appropriations Resolution, 2007 H.R.2764 - Consolidated Appropriations Act, 2008 H.R.3162 - Children's Health and Medicare Protection Act of 2007

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.3963 – Children’s Health Insurance Program Reauthorization Act of 2007 H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007 H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007 Implementation of DRA (Deficit Reduction Act) S.1893 - Children's Health Insurance Program Reauthorization Act of 2007 S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 S.2221 - Transparency in Medical Device Pricing Act of 2007 S.2499 - Medicare, Medicaid, and SCHIP Extension Act of 2007 S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007 S.Con.Res.21 - Concurrent Resolution on the Budget for Fiscal Year 2008 Annual Update for Inpatient Hospital Prospective Payment System H.J.Res.20 - Revised Continuing Appropriations Resolution, 2007 H.R.2764 - Consolidated Appropriations Act, 2008 H.R.3162 - Children's Health and Medicare Protection Act of 2007

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

* H.R. 3162, Children's Health and Medicare Protection Act of 2007; H.R. 976, Small Business Tax Relief Act of 2007; H.R. 562, Medicare Long-Term Care Hospital Improvement Act of 2007; S. 338, Medicare Long-Term Care Hospital Improvement Act of 2007; S. 1842, Safe Nursing and Patient Care Act of 2007; H.R. 2122, Safe Nursing and Patient Care Act of 2007; H.R. 1459, To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility; S. 543, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007; S. 1490, Federal Employees Electronic Personal Health Records Act of 2007; H.R. 1591, U.S. Troop Readiness, Veterans' Health, and Iraq Accountability Act, 2007; H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FFY 2008 Budget and budget resolutions/Medicare and Medicaid cuts FFY 2008 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2008 Medicare Inpatient Hospital PPS rules CY 2008 Medicare Inpatient Psychiatric Facility PPS rules FFY 2008 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule" rules CY 2008 Medicare Outpatient PPS rules FFY 2008 Medicare Skilled Nursing Facility PPS rules CY 2008 Medicare Home Health Agency PPS rules CY 2008 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 states' Medicaid financing mechanisms Pay for performance 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 HUD Federal housing assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Heath care workforce recruiting and training funding Hospital infection and performance measure reporting Medical error reporting S.354/H.R.534 Medicaid liability reform S.473/H.R.215 Allied health professions reinvestment act of 2005 S.543/H.R.1459 Inpatient rehabilitation facilities' 75% rule mitigation S.544 Patient safety and quality improvement act of 2005 S.681 Umbilical cord blood stem cell research S.896 Physician shortage elimination act of 2007 S.898/H.R.1812 Patient navigator outreach & chronic disease prevention act of 2005 S.933/H.R.2350 rural community hospital assistance act S.1041/H.R.800 Employee free choice act--card check S.1049 Covering Kids Act of 2005 S.1262/H.R.2234 Health technology to enhance quality act of 2005 & 21st century health information act s.1348 National immigration reform bill S.1355 & S.1262 Better healthcare through information technology act S.1356/H.R.3617 Medicare value purchasing act of 2005 S.1418 Wired for health care quality act S.1481/H.R.2497 Fair and reliable medical justice act S.1604 Nursing education and quality of health care act of 2007 S.1693 Health information exchange--funding for IT S.1784 National medical error disclosure & compensation act of 2005 S.1955 Health insurance marketplace modernization & affordability act of 2005 S.3042 All-hazards public health emergency & bioterrorism preparedness & response act H.R.139 Health improvement and professionals act of 2005 H.R.534/H.R.880 Rural health equity act H.R.1663 Medicare Mental health modernization act of 2007 H.R.2050 Medicaid psychiatric hospital fairness act H.R.2122 Mandatory overtime limits for nurse H.R.2206 Emergency supplemental spending bill H.R.3173 Nurse faculty higher education act H.R.3373/S.1405 Preserving patient access to inpatient rehabilitation hospitals act H.R.3607 The future of health care-granting access to innovation in America act H.R.4157 Health information technology promotion act of 2005/hospital pricing transparency S.4 Health Technology to Enhance Quality Act of 2005 S.22 Medical Care Access Protection Act of 2006 S.23 Healthy Mothers and Healthy Babies Access S.338/H.R.985 Bipartisan Medicaid Commission

Client expense: $460,000 · 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

HR 3025 HR 562 S 1107 HR 1459 S 1893 HR 3162 S 338 HR 976 S 543

Client expense: $860,000 · Firm income: Not reported

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

S 329 / HR 552 - Provide coverage for cardiac and pulmonary rehabilitation services. HR 2244 - Provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. HR 1809 - Eliminate the in home restriction for Medicare coverage of mobility services. S 749 - Permit Medicare - eligible seniors to elect to receive a voucher for HSAs or high deductible health insurance HR 1774 Establish separate definition of outpatient speech-language pathology services. S 173 - Establish Medicare health savings accounts. S 321- Pilot projects for home health agencies to utilize home monitoring and communications technologies. S 338 / HR 562 - Establish facility and patient criteria for long-term care hospitals. S 543 / HR 1459 - Extend the 60% compliance threshold used to determine IRF status. S 630 / HR 1563 - Provide for a minimum payment rate by Medicare Advantage organizations for services at critical access hospitals and rural health clinics. HR 1013- Prohibit approval or continuation of Title XXI section 1115 waivers that provide coverage to non-pregnant adults under SCHIP. HR 1017- Improve requirements under Medicaid for items and services furnished in or through an educational setting. HR 1111- Provide health coverage for every uninsured child through Medicaid and SCHIP. HR 1535- Children's Health First Act - expansion of SCHIP. HR 1329 - Guaranteed Access for SCHIP's Target Population Act. S 95 - Provide health coverage for every uninsured child through Medicaid and SCHIP. S 1281 / HR 2034 - Medicare for All Act S450 / HR 748 - Medicare Access to Rehabilitation Services Act. S 932/HR 1552 -Medicare Direct Access to Physical Therapy. HR 1846- Medicare Access to Physical Medicine and Rehabilitation Act. S 578 /HR 1017 - Improve requirements under Medicaid for items and services furnished in through an educational setting

Client expense: $857,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

workforce, HR3043/S1710, S 543/HR 1459; payment: HR 2206, HR 1480/1741/S 787, Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, HR 882, HR 552/S 329 ; self referral ; quality S 1226, HR 1666, S 465; rehabilitation hospitals, S543/HR 1459; rural hospitals, HR 2860, S 1605, S 1595; long term care hospitals: HR 562/S338 ; Medicaid reform, HR 2512, HR 2147, HR1111, HR 1878; SCHIP: S 1224, S 895/HR 1535; Labor HR 2122, S 1639, HR800/S1041, HR 2123, HR 378, HR 1644, HR1111, HR 2147; regulations including, but not limited to, provisions of PL 106-554, PL 108-173, PL 109-171; the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P); Medicare and Medicaid Reimbursement issues including HR 2055, HR 2606, S Con Res 21/H Con Res 99, HJ Res. 20, S 355;

Client expense: $380,000 · 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), SENATE, White House Office

H.R. 1459 To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. H.R. 3162 - Children's Health and Medicare Protection Act of 2007 To amend titles XVIII, 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. S. 338 - Medicare Long-Term Care Hospital Improvement Act of 2007 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. 543 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 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. 787 A bill to impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program. H.R. 562 - Medicare Long-Term Care Hospital Improvement Act of 2007 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.

Client expense: $1,160,000 · Firm income: Not reported

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

Health Information Act (S.1262/H.R.2234); Better Healthcare Through Information Technology Act (S.1355/S.1262); Medicare Value Purchasing Act of 2005 (S.1356/H.R.3617); Wired for Health Care Quality Act (S.1418); Nursing Education and Quality of Health Care Act of 2007 (S.1604); Rural Health Equity Act (H.R.534/H.R.880); Inpatient Rehabilitation Facilities' 75% Rule Mitigation; Mandatory Overtime Limits for Nurses (H.R.2122); FFY 2008 Budget and budget Resolutions/Medicare and Medicaid Cuts; FFY 2008 Medicare Inpatient Rehabilitation Facility PPS and 75% Rules; Medicare Skilled Nursing Facility PPS Rules; CMS proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; Hospital Pricing Transparency; Medicaid Regulations Affecting States' Medicaid Financing Mechanisms; Coverage for the Uninsured; Emergency Preparedness; Medicare Wage Index; Hospital Infection Reporting; Medical Error Reporting Health Technology to Enhance Quality Act of 2005 (S4); Medical Care Access Protection Act of 2006 (S.22); Bipartisan Medicaid Commission (S.338/H.R.985); Medicaid Liability Reform (S.354/H.R.534); IP Rehabilitation Facilities' 75% Rule Mitigation (S.543); Patient Safety and Quality Improvement Act of 2005 (S.544); Physician Shortage Elimination Act of 2007 (S.896); Rural Community Hospital Assistance Act (S.933/H.R.2350); Health Technology to Enhance Quality Act of 2005 & the 21st Century

Client expense: Not reported · Firm income: Not reported

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

Not-for-profit hospital tax-exempt status Medicaid regulations affecting states’ Medicaid financing mechanisms Pay for Performance 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 Dept. of Housing and Urban Development's Federal Housing Assistance mortage 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 S.354/H.R.534 Medicaid Liability Reform S.473/H.R.215 Allied Health Professions Reinvestment Act of 2005 Act S. 543 Inpatient Rehabilitation Facilities 75% Rule of Mitigation S.544 Patient Safety and Quality Improvement Act of 2005 S.681 Umbilical Cord Blood Stem Cell Research S.896 Physician Shortage Elimnation Act of 2007 S.898/H.R.1812 Patient Navigator Outreach & Chronic Disease Prevention Act of 2005 S.933/H.R.2350 Rural Community Hospital Assistance Act S.1041/H.R.800 Employee Free Choice Act - Card Check S.1049 Covering Kids Act of 2005 S.1262/H.R.2234 Health Technology to Enhance Quality Act of 2005 & the 21st Century Health Information Act S.1355 & S.1262 Better Healthcare Through Information Technology Act S.1356/H.R.3617 Medicare Value Purchasing Act of 2005 S.1348 National Immigration Reform Act S.1356/H.R.3617 Medicare Value Purchasing Act of 2005 S.1418 Wired for Health Care Quality Act S.1481/H.R.2497 Fair and Reliable Medical Justice Act S. 1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange - funding for IT S.1784 National Medical Error Disclosure & Compensation Act of 2005 S.1955 Health Insurance Marketplace Modernization & Affordability Act of 2005 S.3042 All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act H.R.139 Health Improvement and Professionals Act of 2005 H.R.534 Rural Health Equity Act H.R.880 Rural Health Equity Act H.R. 1459 Inpatinet Rehabilitation Facilities 74% Rule Mitigation H.R. 1663 Medicare Mental Health Modernization Act of 2007 H.R. 2050 Medicaid Psychiatric Hospital Fairness Act H.R. 2122 Mandatory Overtime Limits for Nurses H.R. 2206 Emergency Supplemental Spending Bill H.R.3173 Nurse Faculty Higher Education Act H.R.3373/S.1405 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act H.R.3607 The Future of Health Care-Granting Access to Innovation in America Act H.R.4157 Health Information Technology Promotion Act of 2005/Hospital Pricing Transparency FFY 2008 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2008Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2008 Medicare Inpatient Hospital PPS Rules CY 2008 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2008 Medicare Inpatient Rehabilitation Facility PPS and “75% Rule”, Rules CY 2008 Medicare Outpatient PPS Rules FFY 2008 Medicare Skilled Nursing Facility PPS Rules CY 2008 Medicare Home Health Agency PPS Rules CY 2008 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 S.4 Health Technology to Enhance Quality Act of 2005 S.22 Medical Care Access Protection Act of 2006 S.23 Healthy Mothers and Healthy Babies Access S.338/H.R.985 Bipartisan Medicaid Commission

Client expense: $20,000 · 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

HR 562 and S 338 Medicare Long Term Care Hospital Improvement Act - all provisions - lobbying in support of passage

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Medicare Long-Term Care Patient Safety and Improvement Act of 2007 (H.R. 3057), Medicare Long-Term Care Hospital Improvement Act of 2007 (S. 338, H.R. 562), Children's Health and Medicare Protection Act of 2007 (H.R. 3162), CMS Final Rule for Long-Term Acute Care Hospitals PPS in FY08 and other administrative regulatory policies

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of Medicare Prescription Drug and Modernization Act of 2003 S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007 S.Con.Res.21 - Concurrent Resolution on the Budget for Fiscal Year 2008 SCHIP Reauthorization/SGR Reform Solutions for Patient Safety & Quality Improvement H.J.Res.20 - Revised Continuing Appropriations Resolution, 2007 H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007 Hospital Charges Implementation of DRA (Deficit Reduction Act)

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE