Community Choice Act of 2007

Ending the Medicare Disability Waiting Period Act, H 154, S 2101 to end Medicare's 24-month waiting period. Medicare Improvements for Patients & Providers Act of 2008 , HR 6331, and related bills, HR 6252, S 3118, including provisions to fix the physician payment rate, delay Medicare competitive bidding for durable medical equipment and exempt complex rehabilitation from competitive bidding altogether -- because of impacts on people who need wheelchairs and other durable medical equipment. cont. S. 3327 - to improve the state plan option under Medicaid providing for home & community-based services -- cjamges tje home and community-based services option in the 2005 Deficit Reduction Act to allow more people to access these services. HR 1845 & S. 6252 - Medicare DMEPOS Competitive Acquisition Reform Act of 2007 regarding competitive bidding for durable medical equiptment. HR 1809/ S 2103 -- Medicare Independent Living Act -- to reverse Medicare regulations and policies that restrict payment for power mobility devices (wheelchairs) to those needed "in the home" rather than in the community -- such as for going to work, school, grocery shopping, medical appointments, places of worship and to accompany childred to school and activities. HR 1621/ S 799 - Community Choice Act of 2007 -- to support Medicaid coverage of community based services such as personal care, activities of daily living, etc. HR 1279 -- Direct Support Professional's Fairness & Security Act -- to support equalization of wages between privately and publicly employed direct support professionals. Community Living Assistance and Supports, CLASS Act S. 1758, Senators Edward Kennedy (D-MA) and Tom Harkin (D-IA) H.R. 3001, Reps. Frank Pallone (D-NJ) and John Dingell (D-MI) Both bills provide for a cash benefit to help obtain services and support. They would establish a national insurance plan to be financed by voluntary payroll deductions to provide benefits to adults who become severely functionally impaired. Participants would not be required to impoverish themselves in order to qualify for benefits. Center for Medicare and Medicaid Services (CMS) -- oppose the Rhode Island 1115 Waiver application that would essentially block grant Medicaid to Rhode Island -- which would jeopardize Medicaid services. Discussions with senior CMS officials about what will be happening with competitive bidding following enactment of HR 6331 that delayed competitive bidding temporarily and exempted complex rehabilitation from competive bidding altogether. Discussions about possible future legislation in the 111th Congress regarding: - physician payment rate - Medicare competitive bidding for durable medical equipment - make permanent some of the temporary delays/moratoria that were included in HR 6331 and related bills - seek permanent repeals of Medicaid rules that were delayed by legislation (e.g. enactment of HR 5613) - increasing the federal share of Medicaid (known as FMAP) including increased FMAP for direct support workers.

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

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

S 334, The Healthy Americans Act; HR 676, Expanded and Improved Medicare for All Act; S 1019, Universal Health Care Choice and Access Act; HR 1688 and S 1564, All Healthy Children Act of 2007; S 799, Community Choice Act of 2007; HR 1368, CONTINUED ON NEXT PAGE Personalized Health Information Act of 2007; HR 2014, Health Equity and Accountability Act of 2007; HR 1952, National Health Information Incentive Act of 2007; S 1455, National Health Information Technology and Privacy Advancement Act of 2007; S 716, Consortium on the Impact of Technology in Aging Health Services Act of 200: issues impacting employer costs.

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

Government targets: HOUSE OF REPRESENTATIVES, Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS)

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

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

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

H.R.4, Medicare Prescription Drug Price Negotiation Act H.R.2147, Healthy Kids Act (Emanuel) H.R.2945, Medicare Advantage Truth in Advertising ActH.R.3025, Medicare Prescription Drug Savings for Our Seniors Act H.R.3061, Medicare Part D. Drug Class Protection Act H.R.3162, Children's Health and Medicare Protection Act H.R.3963, Children's Health Insurance Program Reauthorization Act H.R.5998, Protecting Children's Health Coverage Act H.R.6331, Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) H.R.6388, GAO Improvement Act (provisions relating to access to Medicare Part C/Part D data) S.706, Medicare Advantage Stabilization Fund S.799, Community Choice Act S.1224, Children's Health Insurance Program Reauthorization Act S.1893, Children's Health Insurance Program Reauthorization Act S.2219, Medicare Prescription Drug Savings and Choice Act S.3101, Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) S.3118, Preserving Access to Medicare Act (provisions relating to Medicare Advantage, Medicare Part D, Medicaid, and electronic prescribing)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Discussed with Senate staff possible introduction of a Direct Support Professional bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill To provide for a temporary increase in the Federal Medical Assistance Percentage, and for other purposes--supported FMAP increase (H.R. 5268) A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Empowered at Home Act of 2008: aimed at removing existing barriers to the new Medicaid Section 1915(i) HCBS benefit, strengthening HCBS services in order to prevent or decrease the likelihood of institutionalization, provide state assistance to facilitate HCBS services, improve purchase of long term care, and improve CMS collection of state data regarding number of individuals, expenditures, types of services, and waiting lists. S. 3327 would increase income eligibility from current 150% of FPL to 300% of SSI; eliminate option to waive statewideness; expand scope of services to include "other services", and eliminate option to limit number of eligible individuals and extends time period for eligibility (S. 3327)--supported bill

Client expense: $44,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 898/HR 1560 - Alzheimer's Breakthrough Act of 2007 S 558/HR 1424 - Mental Health Parity Act of 2007 S 325/HR 506 - Health Partnership Act H.R.6282/S 2950 - Helping HANDS for Autism Act of 2008 H.R. 1669/S 982 - Positive Aging Act of 2007 H.R. 1424 - Emergency Economic Stabilization Act of 2008 H.R. 3 - Stem Cell Research Enhancement Act of 2007 H.R. 1621/ S 799- Community Choice Act of 2007 S. 2267- Americans Giving Care to Elders Act of 2007 S. 1758/HR 3001- Community Living Assistance Services and Supports Act H.R. 4897/S. 1854- Stop Senior Suicide Act H.R. 977 - The Genomic Research and Accessibility Act Long-Term Care Social Service Block Grant S 937/HR 1881 - Expanding the Promise for Individuals With Autism Act of 2007 HR 7202- Temporary Tax Relief Act of 2008 HR 6049- Renewable Energy and Job Creation Act of 2008

Client expense: $34,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 450 and HR 748, The Medicare Access to Rehabilitation Services Act of 2007 - All provisions, passage. HR 1846, The Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 - Opposed based on quality, cost accountability, and scope of practice concerns. S. 1224 and HR 3269, Children's Health Insurance Program (CHIP) Reauthorization Act of 2007 - Advocated in support of the CHIP program and an expanded role for occuaptional therapy. H.R. 3162, Children's Health and Medicare Protections Act of 2007 (CHAMP) - Advocated for Medicare provision regarding therapy caps, 75% rule on inpatient rehabilitation facilities, SGR cuts and Medicaid provisions. S. 799 and H.R. 1621, The Community Choice Act - Supported all provisions. S. 578 and H.R. 1017, Protecting Children's Health in Schools Act - supported passage and maintaining Medicaid funding for school based administrative claiming and transportation services. H.R. 1809 and S. 2103, Medicare Independent Living Act - Supported the provision of improved access to mobility devices for people with disabilities. H.R. 4082 and S. 1980, Long-term Care Quality and Modernization Act of 2007 - Advocated for inclusion of occupational therapy in quality reporting. S. 932 and H.R. 1552, Medicare Patient Access to Physical Therapist Act of 2007 - Advocated regarding impact on occupational therapy. H.R. 1663, Medicare Mental Health Modernization Act of 2007 - Advocated for passage and improved role for occupational therapy. S. 1628, Nurse Faculty and Physical Therapist Education Act of 2007 - Advocated for inclusion of occupational therapy loan repayment. H.R. 4248, Ensuring Medicare Access to Recreational Thearpy Act - Opposed findings language referring to functional capacities and worked to amend that language. No bill number - Medicaid Rehabilitation Services Proposed Rule - Before Congress advocated for moratorium; opposed proposal to restrict the reimbursement of services under the rehabilitation option. HR 5704, The Medicare Home Health Flexibility Act: Advocated for the promotion of occupational therapy in home health under Medicare. No bill number: Advocated and educated about the role of occupational therapy in mental health practice. HR 5590, Medicare Oral Health Rehabilitative Enhancement Act - inclusion of occupational therapy coverage language. No bill number - Preserving Access to Medicare Act - advocated for passage and inclusion of Part B outpatient therapy cap exceptions process extension, physician fee schedule update, and physician quality review incentive (PQRI). HR 2231 and S 2931 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007 - advocated for exemption of complex rehab from competitive bidding for DMEPOS. H.R. 7130 and S. 3631 - Medically Fragile Childrens Act of 2008 - Advocated for provision of occupational therapy. H.R. 6878 - Medicare Orthotics and Prosthetics Improvement Act of 2008 - Opposed due to negative impact on occupational therapy scope of practice and reimbursement.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 799/H.R. 1621, the "Community Choice Act" H.R. 2231/S. 2931, the "Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007"

Client expense: $42,254 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Improvements for Patients & Providers Act of 2008, HR 6331, and related bills, HR 6252, S. 3118, including provisions to fix the physician payment rate, delay Medicare competitive bidding for durable medical equipment and exempt complex rehabilitation from competitive bidding altogether (because of impacts on popel who need wheelchairs and other durable medical equipment), provider Medicare mental health parity, delay cuts to Medicare therapies, require Medicare Part D to cover cont. certain drugs, strengthen CMS authority to require Part D plans to ensure broad coverage on prescription durg plan formularies, improve access to the Medicare Savings Program, eliminate Medicare Part D enrollment penalties, limit out-of-pocket costs for people who are qualified Medicare beneficiaries and people who are eligible for both Medicare and Medicaid (dual eligibles), simplify and align Medicare low-income assistance programs, bring outdated asset limits in line with today's cost of living, improve outreach and participation for those people currently eligible. S 3327 -- to improve the state plan option under Medicaid providing for home and community-based services -- changes the home and community-based services option in the 2005 Deficit Reduction Act to allow more people to access these services. HR 1845 & S. 6252 - Medicare DMEPOS Competitive Acquisition Reform Act of 2007 regarding competitive bidding for durable medical equiptment. HR 1809/ S 2103 -- Medicare Independent Living Act -- to reverse Medicare regulations and policies that restrict payment for power mobility devices (wheelchairs) to those needed "in the home" rather than in the community -- such as for going to work, school, grocery shopping, medical appointments, places of worship and to accompany childred to school and activities. HR 1621/ S 799 - Community Choice Act of 2007 -- to support Medicaid coverage of community based services such as personal care, activities of daily living, etc. HR 1279 -- Direct Support Professional's Fairness & Security Act -- to support equalization of wages between privately and publicly employed direct support professionals. Discussions with senior CMS officials about what will be happening with competitive bidding following enactment of HR 6331 that delayed competitive bidding temporarily and exempted complex rehabilitation from competive bidding altogether. Discussions about possible future legislation to: -- make permanent some of the temporary delays/moratoria that were included in HR 6331 and related bills -- protect the Medicaid waiver application process and require transparency on behalf of states and CMS. -- delay the Medicare 24-month waiting period -- seek permanent repeal of Medicaid rules that were delayed by legislation (e.g. enactment of HR 5613)

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

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

S. 450 and HR 748, The Medicare Access to Rehabilitation Services Act of 2007 - All provisions, passage. HR 1846, The Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 - Opposed based on quality, cost accountability, and scope of practice concerns. S. 1224 and HR 3269, Children's Health Insurance Program (CHIP) Reauthorization Act of 2007 - Advocated in support of the CHIP program and an expanded role for occuaptional therapy. H.R. 3162, Children's Health and Medicare Protections Act of 2007 (CHAMP) - Advocated for Medicare provision regarding therapy caps, 75% rule on inpatient rehabilitation facilities, SGR cuts and Medicaid provisions. S. 799 and H.R. 1621, The Community Choice Act - Supported all provisions. S. 578 and H.R. 1017, Protecting Children's Health in Schools Act - supported passage and maintaining Medicaid funding for school based administrative claiming and transportation services. H.R. 1809 and S. 2103, Medicare Independent Living Act - Supported the provision of improved access to mobility devices for people with disabilities. H.R. 4082 and S. 1980, Long-term Care Quality and Modernization Act of 2007 - Advocated for inclusion of occupational therapy in quality reporting. S. 932 and H.R. 1552, Medicare Patient Access to Physical Therapist Act of 2007 - Advocated regarding impact on occupational therapy. H.R. 1663, Medicare Mental Health Modernization Act of 2007 - Advocated for passage and improved role for occupational therapy. S. 1628, Nurse Faculty and Physical Therapist Education Act of 2007 - Advocated for inclusion of occupational therapy loan repayment. H.R. 4248, Ensuring Medicare Access to Recreational Thearpy Act - Opposed findings language referring to functional capacities and worked to amend that language. HR 2642 (PL 110-252) Iraq War Supplemental Appropriations -Advocated for moratorium on Medicaid School-based Transportation and Administrative Claiming Costs and opposed elimination of reimbursement for rehab service option. No bill number - Medicaid Rehabilitation Services Proposed Rule - Before Congress advocated for moratorium; opposed proposal to restrict the reimbursement of services under the rehabilitation option. HR 5704, The Medicare Home Health Flexibility Act: Advocated for the promotion of occupational therapy in home health under Medicare. No bill number: Advocated and educated about the role of occupational therapy in mental health practice. HR 6331 and S 3101, Medicare Improvement for Patients and Providers act of 2008 - Advocated for passage and inclusion of following provisions: Part B Outpatient therapy cap exceptions process extension, physician fee schedule update; reduction in copay for Medicare mental health provisions, and delay competitive bidding for DMEPOS; and PQRI. HR 5590, Medicare Oral Health Rehabilitative Enhancement Act - inclusion of occupational therapy coverage language. No bill number - Preserving Access to Medicare Act - advocated for passage and inclusion of Part B outpatient therapy cap exceptions process extension, physician fee schedule update, and physician quality review incentive (PQRI). HR 2231 and S 2931 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007 - advocated for exemption of complex rehab from competitive bidding for DMEPOS. H.R. 7130 and S. 3631 - Medically Fragile Childrens Act of 2008 - Advocated for provision of occupational therapy. H.R. 6878 - Medicare Orthotics and Prosthetics Improvement Act of 2008 - Opposed due to negative impact on occupational therapy scope of practice and reimbursement.

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621, and H.R. 6331), as well as initiatives aimed at expanding health coverage (including but not limited to S. 334).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799, H.R. 1621, and H.R. 6331), as well as initiatives aimed at expanding health coverage (including but not limited to S. 334).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621, and H.R. 6331), as well as initiatives aimed at expanding health coverage (including but not limited to S. 334).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage - HR 6331, Medicare Improvements for Patients and Providers Act of 2008; Proposed legislation re this issue. Medigap insurance market issues - Proposed legislation re these issues. Medicare/Medicaid issues - S 706, To amend title XVIII of the Social Security Act to repeal the MA Regional Plan Stabilization Fund; S 130, Medicare Cost Contract Extension and Refinement Act of 2007; HR 1990, Medicare Cost Contract Extension and Refinement Act of 2007; HR 4, Medicare Prescription Drug Price Negotiation Act of 2007; S 3, Medicare Prescription Drug Price Negotiation Act of 2007; S 1102, Part D Equity for Low-Income Seniors Act of 2007; S 1103, Helping Fill the Medicare Rx Gap Act of 2007; S 1107, Home and Community Services Copayment Equity Act of 2007; S 1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007; HR 2945, Medicare Advantage Truth in Advertising Act of 2007; S 799, Community Choice Act of 2007; S 1544, Medicare Quality Enhancement Act of 2007; S 1507, Access to Medicare Data Act of 2007; S 1827, Pharmacist Access and Recognition in Medicare (PhARM) Act of 2007; HR 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007; HR 3061, Medicare Part D Drug Class Protection Act of 2007; HR 3162, Children's Health and Medicare Protection Act of 2007; HR 976, Children's Health Insurance Program Reauthorization Act of 2007; S 1893, Children's Health Insurance Program Reauthorization Act of 2007; S 1954, Pharmacy Access Improvement (PhAIm) Act of 2007; HR 3963, Children's Health Insurance Program Reauthorization Act of 2007; S 2219, Medicare Prescription Drug Savings and Choice Act of 2007; HR 3932, Medicare Prescription Drug Savings and Choice Act of 2007; S 2408, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; HR 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007; S 1200, Indian Health Care Improvement Act Amendments of 2008; HR 5480, Medicare Funding Warning Response Act of 2008; S 2662, Medicare Funding Warning Response Act of 2008; HR 5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; HR 6388, Government Accountability Office Improvement Act of 2008; HR 5998, Fair and Justifiable Credit Card Interest Rate Act of 2008; S 2819, Economic Recovery in Health Care Act of 2008; HR 6359, Medicare Beneficiary Protection Act of 2008; HR 6365, Medicare Special Needs Plans Extension and Amendments Act of 2008; HR 5613, Protecting the Medicaid Safety Net Act of 2008; S 2620, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid program; S 3101, Medicare Improvements for Patients and Providers Act of 2008; HR 5683, Government Accountability Office Act of 2008; HR 7110, Job Creation and Unemployment Relief Act of 2008; S 3560, QI Program Supplemental Funding Act of 2008; HR 7077, QI Program Supplemental Funding Act of 2008; SJRes 44, blocking implementation of SCHIP; HRes 1368, Resolved, That section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 shall not apply during the remainder of the 110th Congress; S 3604, Emergency Supplemental.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Regulation on State Rehabilitation Option--opposed regulation To provide for a temporary increase in the Federal Medical Assistance Percentage, and for other purposes--supported FMAP increase (H.R. 5268) A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Resolution Designating the week beginning September 8, 2008, as National Direct Support Professionals Recognition Week(S.Res. 613)--supported resolution Empowered at Home Act of 2008: aimed at removing existing barriers to the new Medicaid Section 1915(i) HCBS benefit, strengthening HCBS services in order to prevent or decrease the likelihood of institutionalization, provide state assistance to facilitate HCBS sevices, improve purchase of long term care, and improve CMS collection of state data regarding number of individuals, expenditures, types of services, and waiting lists. S. 3327 would increase income eligibility from current 150% of FPL to 300% of SSI; eliminate option to waive statewideness; expand scope of services to include "other services", and eliminate option to limit number of eligible individuals and extends time period for eligibility (S. 3327)--supported bill

Client expense: $56,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Client expense: $1,630,000 · Firm income: Not reported

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

HR 6331, Medicare Improvements for Patients and Providers Act - for provisions to renew therapy caps exceptions process HR 5268/S 2620 - temporary increase in federal Medicaid matching funds - for HR 3784, requiring separate reporting of staffing expenditures on nursing homes' Medicare cost reports - for S 799/HR 1621, Community Choice Act, allowing Medicaid coverage of community-based attendant services - for S 3327, Empowered at Home Act, to improve Medicaid coverage of adult day services - for

Client expense: $100,140 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), SENATE

S 334, The Healthy Americans Act; HR 676, Expanded and Improved Medicare for All Act; S 1019, Universal Health Care Choice and Access Act; HR 1688 and S 1564, All Healthy Children Act of 2007; S 799, Community Choice Act of 2007; HR 1368, CONTINUED ON NEXT PAGE Personalized Health Information Act of 2007; HR 2014, Health Equity and Accountability Act of 2007; HR 1952, National Health Information Incentive Act of 2007; S 1455, National Health Information Technology and Privacy Advancement Act of 2007; S 716, Consortium on the Impact of Technology in Aging Health Services Act of 200: issues impacting employer costs.

Client expense: Not reported · Firm income: $200,000

Government targets: HOUSE OF REPRESENTATIVES, Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS)

H.R.4, Medicare Prescription Drug Price Negotiation Act H.R.2147, Healthy Kids Act (Emanuel) H.R.2945, Medicare Advantage Truth in Advertising ActH.R.3025, Medicare Prescription Drug Savings for Our Seniors Act H.R.3061, Medicare Part D. Drug Class Protection Act H.R.3162, Children's Health and Medicare Protection Act H.R.3963, Children's Health Insurance Program Reauthorization Act H.R.5998, Protecting Children's Health Coverage Act H.R.6331, Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) H.R.6388, GAO Improvement Act (provisions relating to access to Medicare Part C/Part D data) S.706, Medicare Advantage Stabilization Fund S.799, Community Choice Act S.1224, Children's Health Insurance Program Reauthorization Act S.1893, Children's Health Insurance Program Reauthorization Act S.2219, Medicare Prescription Drug Savings and Choice Act S.3101, Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) S.3118, Preserving Access to Medicare Act (provisions relating to Medicare Advantage, Medicare Part D, Medicaid, and electronic prescribing)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 898/HR 1560 - Alzheimer's Breakthrough Act of 2007 S 558 - Mental Health Parity Act of 2007 S 325/HR 506 - Health Partnership Act H.R.6282/S 2950 - Helping HANDS for Autism Act of 2008 H.R. 1669/S 982 - Positive Aging Act of 2007 H.R. 1424 - Emergency Economic Stabilization Act of 2008 H.R. 3 - Stem Cell Research Enhancement Act of 2007 H.R. 1621/ S 799- Community Choice Act of 2007 S. 2267- Americans Giving Care to Elders Act of 2007 S. 1758/HR 3001- Community Living Assistance Services and Supports Act H.R. 4897- Stop Senior Suicide Act H.R. 977 - The Genomic Research and Accessibility Act Long-Term Care Social Service Block Grant S 1758/HR 30001 - CLASS Act S 937/HR 1881 - Expanding the Promise for Individuals With Autism Act of 2007 HR 6983 - To amend section 712 of the Employee Retirement Income Security Act of 1974, section 2705 of the Public Health Service Act, and section 9812 of the Internal Revenue Code of 1986 to require equity in the provision of mental health and substance-related disorder benefits under group health plans, and for other purposes. HR 7202- Temporary Tax Relief Act of 2008 HR 6049- Renewable Energy and Job Creation Act of 2008

Client expense: $51,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

S.799/H.R. 1621, the "Community Choice Act" H.R. 2231/S. 2931, the "Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007"

Client expense: $77,119 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

Client expense: Not reported · Firm income: Not reported

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

Client expense: Not reported · Firm income: Not reported

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel); H.R. 1535: Children's Health First Act (Dingell); H.R. 1663: Medicare Mental Health Modernization Act (Stark) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2147: Healthy Kids Act (Emanuel); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 2642: Supplemental Appropriations Act (provisions relating to moratoria on Medicaid regulations); H.R. 2842: Childrens Health Protection Act (Schwartz); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3195: ADA Amendments Act (Hoyer); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5550: Coverage for Young Adult Dependents of Federal Employees (Davis); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); H.R. 5683: GAO Act (provisions relating to access to Medicare part C/part D data) (Davis); H.R. 5781: Federal Employees Paid Parental Leave Act (Maloney); H.R. 5840: Insurance Information Act (Kanjorski); H.R. 5918: Small Business Health Options Program Act (Barrow); H.R. 5923: Patients Health Care Reform Act (Shadegg); H.R. 5955: Making Health Care More Affordable Act (Walberg); H.R. 5998: Protecting Children's Health Coverage Act (Pallone); H.R. 6071: Health Care Consumer Protection Act (provisions relating to reinstatement of health insurance following nonpayment of premiums) (Forbes); H.R. 6081: Heroes Earning Assistance and Relief Tax Act (mental health parity and FSA provisions); H.R. 6142: Lawsuits Against Employer-Sponsored Disability Benefit Plans (Andrews); H.R. 6210: Small Business Health Options Program Act (Kind-English); H.R. 6331: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) (Rangel-Dingell); H.R. 6388: GAO Improvement Act (provisions relating to access to Medicare part C/part D data) (Waxman); H.R. 6359: Medicare Beneficiary Protection Act (Biggert); H.R. 6365: Medicare Special Needs Plans Extension and Amendments Act (Kind); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 401: Keep Children Covered Act (Rockefeller); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 895: Children's Health First Act (Clinton); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1224: Children's Health Insurance Program Reauthorization Act (Rockefeller); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2819: Economic Recovery in Health Care Act (provisions relating to Medicaid funding) (Rockefeller); S. 2948: Small Business Empowerment Act (Brown); S. 2818: Small Business Health Plans Act (Enzi); S. 2999: Access to Cancer Clinical Trials Act (Brown); S. 3068: Equity in Prescription Insurance and Contraceptive Coverage Act (Snowe); S. 3101: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) (Baucus); S. 3115: Childrens Health Protection Act (Lautenberg); S. 3118: Preserving Access to Medicare Act (provisions relating to Medicare Advantage, Medicare Part D, Medicaid, and electronic prescribing)(Grassley). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including encounter data issues) bidding and payment issues (including MA coding intensity, Part D reinsurance, low income subsidies, application process, and audits), application process, and audits, benefit design rules, SSA and CMS premium withhold processing issues, systems issues affecting enrollment and disenrollment processing, enrollment rules, marketing materials review and approval, marketing activities, including conduct of brokers and agents and plan sponsor marketing staff and issues raised by CMS about Private Fee-for-Service (PFFS) plan marketing, measurement and oversight of plan performance including Special Needs Plans (SNPs); grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration issues for Special Needs Plans (SNPs); Federal premption of State authorization over MA and Part D plans, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval, systems issues affecting enrollment and disenrollment processing, payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting inititiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs) and federal matching funds for graduate medical education; coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

Client expense: $1,850,000 · 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), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of

Medicare Improvements for Patients and Providers Act of 2008, HR. 6331, and related bills, HR 6252, S 3118, including provisions to fix the physician payment rate, delay Medicare competitive bidding, exempt complex rehab from competitive bidding (because of the impact of competitive bidding on people who need wheelchairs and other durable medical equipment) provide Medicare mental health parity, delay cuts to Medicare therapies, require Medicare Part D to cover certain drugs, strengthen CMS authority to require Part D plans to ensure broad coverage on prescription drug plan formularies, improve access to the Medicare Savings Program, eliminate Medicare Part D late enrollment penalties, limit out-of-poicket costs for dual eligibles and qualified Medicare beneficiaries, revise the definition of medically accepted indication for drugs, simplify and align Medicare low-income assistance programs, bring outdated asset limits in line with today's cost of living, improve outreach and participation for those currently eligible. HR 1845 and S. 1428 - Medicare Durable Medical Equipment Act of 2007 regarding competitive bidding for durable medical equipment (DME). S. 3144 and HR 6252 -- Medicare DMEPOS Competitive Acquisition Reform Act of 2007, to delay implementation of Medicare competitive bidding program. HR 2642 - Iraq War supplemental appropriation -- support provision to put a moratorium on certain Medicaid regulations. HR 5613 - Protecting Medicaid Safety Net -- support provision for moratoria on existing reguslations including those that would severely restrict rehabilitation and targeted case management. Medicare Independent Living Act (HR 1809/S 2103) to reverse Medicare regulations that restrict payment for power mobility devices (wheelchairs) to those needed "in the home" rather than in the community -- such as for going to work, school, grocery store, medical appointments, places of worship, and to accompany children to school and activities. Community Choice Act of 2007 (HR 1621/S 799) -- support Medicaid coverage of community based services such as personal care, activities of daily living, etc. Direct Support Professional's Fairness & Security Act (HR 1279) -- support equalization of wages between privately and publicly employed direct support professionals. Promoting Wellness for People with Disabilities Act of 2007 (S. 1050) -- support accessibility of medical examination and diagnostic equipment for people with disabilities. Letter to President Bush and Health & Human Services Secretary Leavitt urging CMS to change the policy in its directives of August 17, 2007 and May 7, 2008 in order to eliminate the hurdles for states to provide SCHIP (State Childrens Health Insurance Plan) coverage to uninsured children. HR 2642 -- supplemental appropriations for military consturction, Dept. of Veterans Affairs and related agencies for FY 08, including: Title III - GI bill -- Veterans Educational Assistance of 2008; Title V -- Medicaid provisions including amending the Medicare, Medicaid and SCHIP Extension Act of 2007 to extend moratorium on restrictions relating to Medicaid coverage or payment for rehabilitation services or school-based administration and school-based transportation, moratoria on specific Medicaird reguslations,

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Guidance on SCHIP income eligibility for program--opposed guidance CMS Regulation on State Rehabilitation Option--opposed regulation A bill to provide a temporary increase in Federal Medical Assistance Percentage (S. 2620 and H.R. 5268)--supported FMAP increase A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Resolution Designating the week beginning September 8, 2008, as National Direct Support Professionals Recognition Week(S.Res. 613)--supported resolution

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 334, The Healthy Americans Act; HR 676, Expanded and Improved Medicare for All Act; S 1019, Universal Health Care Choice and Access Act; HR 1688 and S 1564, All Healthy Children Act of 2007; S 799, Community Choice Act of 2007; HR 1368, CONTINUED ON NEXT PAGE Personalized Health Information Act of 2007; HR 2014, Health Equity and Accountability Act of 2007; HR 1952, National Health Information Incentive Act of 2007; S 1455, National Health Information Technology and Privacy Advancement Act of 2007; S 716, Consortium on the Impact of Technology in Aging Health Services Act of 200: issues impacting employer costs.

Client expense: Not reported · Firm income: $210,000

Government targets: HOUSE OF REPRESENTATIVES, Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS)

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 450 and HR 748, The Medicare Access to Rehabilitation Services Act of 2007 - All provisions, passage. HR 1846, The Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 - Opposed based on quality, cost accountability, and scope of practice concerns. S. 1224 and HR 3269, Children's Health Insurance Program (CHIP) Reauthorization Act of 2007 - Advocated in support of the CHIP program and an expanded role for occuaptional therapy. H.R. 3162, Children's Health and Medicare Protections Act of 2007 (CHAMP) - Advocated for Medicare provision regarding therapy caps, 75% rule on inpatient rehabilitation facilities, SGR cuts and Medicaid provisions. S. 799 and H.R. 1621, The Community Choice Act - Supported all provisions. S. 578 and H.R. 1017, Protecting Children's Health in Schools Act - supported passage and maintaining Medicaid funding for school based administrative claiming and transportation services. H.R. 1809 and S. 2103, Medicare Independent Living Act - Supported the provision of improved access to mobility devices for people with disabilities. H.R. 4082 and S. 1980, Long-term Care Quality and Modernization Act of 2007 - Advocated for inclusion of occupational therapy in quality reporting. S. 932 and H.R. 1552, Medicare Patient Access to Physical Therapist Act of 2007 - Advocated regarding impact on occupational therapy. H.R. 1663, Medicare Mental Health Modernization Act of 2007 - Advocated for passage and improved role for occupational therapy. S. 1628, Nurse Faculty and Physical Therapist Education Act of 2007 - Advocated for inclusion of occupational therapy loan repayment. H.R. 4248, Ensuring Medicare Access to Recreational Thearpy Act - Opposed findings language referring to functional capacities and worked to amend that language. HR 2642 (PL 110-252) Iraq War Supplemental Appropriations -Advocated for moratorium on Medicaid School-based Transportation and Administrative Claiming Costs and opposed elimination of reimbursement for rehab service option. No bill number - Medicaid Rehabilitation Services Proposed Rule - Before Congress advocated for moratorium; opposed proposal to restrict the reimbursement of services under the rehabilitation option. HR 5704, The Medicare Home Health Flexibility Act: Advocated for the promotion of occupational therapy in home health under Medicare. No bill number: Advocated and educated about the role of occupational therapy in mental health practice. HR 6331 and S 3101, Medicare Improvement for Patients and Providers act of 2008 - Advocated for passage and inclusion of following provisions: Part B Outpatient therapy cap exceptions process extension, physician fee schedule update; reduction in copay for Medicare mental health provisions, and delay competitive bidding for DMEPOS; and PQRI. HR 5590, Medicare Oral Health Rehabilitative Enhancement Act - inclusion of occupational therapy coverage language. No bill number - Preserving Access to Medicare Act - advocated for passage and inclusion of Part B outpatient therapy cap exceptions process extension, physician fee schedule update, and physician quality review incentive (PQRI). HR 2231 and S 2931 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007 - advocated for exemption of complex rehab from competitive bidding for DMEPOS.

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

Government targets: Centers For Disease Control & Prevention (CDC), Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

H 976/S 1893: State Children's Health Insurance Program; HR 3963: Children's Health Insurance Program Reauthorization Act of 2007; Medicare and Medicaid reform; Medicare competitive bidding; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003; HR 1017/S 578 Protecting Children's Health in Schools Act; Federal Medical Assistance Percentage legislation; HR 1333/S 647: Medicare Patient Access to Physical Therapists Act of 2005 HR 748/S 450: Medicare Access to Rehabilitation Services Act; H. Con. Res. 99/S. Con. Res. 21 budget legislation; HR 1621/S 799: Community Choice Act of 2007; HR 3162: Children's Health & Medicare Protection (CHAMP) Act; HR 5613: Protecting the Medicaid Safety Net Act of 2008; HR 6331/S 3101: Medicare Improvements for Patients and Providers Act of 2008; HR 5748: Ryan Dant Health Care Opportunity Act of 2008; HR 2642: Military Construction and Veterans Affairs Appropriation Act of 2008.

Client expense: $121,956 · Firm income: Not reported

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

S 898/HR 1560 - Alzheimer's Breakthrough Act of 2007 S 558 - Mental Health Parity Act of 2007 S 325/HR 506 - Health Partnership Act H.R.6282/S 2950 - Helping HANDS for Autism Act of 2008 H.R. 1669/S 982 - Positive Aging Act of 2007 H.R. 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007 H.R. 3 - Stem Cell Research Enhancement Act of 2007 H.R. 1621/ S 799- Community Choice Act of 2007 S. 2267- Americans Giving Care to Elders Act of 2007 S. 1758/HR 3001- Community Living Assistance Services and Supports Act H.R. 4897- Stop Senior Suicide Act S. 358/HR 493 - Genetic Information Nondiscrimination Act of 2007 H.R. 977 - The Genomic Research and Accessibility Act Long-Term Care Social Service Block Grant S 1758/HR 30001 - CLASS Act S 937/HR 1881 - Expanding the Promise for Individuals With Autism Act of 2007

Client expense: $68,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

Protecting Medicaid Safety Net Act (HR 5613) - moratoria on existing regulations including those that would severely restrict rehabilitation and targeted case management. Medicare Independent Living Act (HR 1809/S2103) to reverse the Medicare regulation that restricts payment for power mobility devices (wheel chairs) to those needed "in the home" rather than in the community (such as for going to work, school, (continued) grocery store, pharmacy, medical appointments, places of worship, to vote, to accompany children to school). Community Choice Act of 2007 (HR 1621/S 799) -- to provide for Medicaid coverage of community based services such as personal care, activities of daily living, etc. Direct Support Professional's Fairness & Security Act (HR 1279) -- to equalize wages between privately and publicly employed direct support personnel. Promoting Wellness for People with Disabilities Act of 2007 (S. 1050) --- to promote accessibility of medical examination and diagnostic equipment for people with disabilities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA), State, Dept of (DOS)

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Guidance on SCHIP income eligibility for program--opposed guidance CMS Regulation on State Rehabilitation Option--opposed regulation CMS Regulation on (Targeted) Case Management--opposed regulation CMS Regulation on Public Provider taxes--opposed regulation A bill to provide a temporary increase in Federal Medical Assistance Percentage (S. 2620 and H.R. 5268)--supported FMAP increase A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill

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

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

S 334, The Healthy Americans Act; HR 676, Expanded and Improved Medicare for All Act; S 1019, Universal Health Care Choice and Access Act; HR 1688 and S 1564, All Healthy Children Act of 2007; S 799, Community Choice Act of 2007; HR 1368, CONTINUED ON NEXT PAGE Personalized Health Information Act of 2007; HR 2014, Health Equity and Accountability Act of 2007; HR 1952, National Health Information Incentive Act of 2007; S 1455, National Health Information Technology and Privacy Advancement Act of 2007; S 716, Consortium on the Impact of Technology in Aging Health Services Act of 2007, issues impacting employer costs.

Client expense: Not reported · Firm income: $200,000

Government targets: HOUSE OF REPRESENTATIVES, Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS)

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel); H.R. 1535: Children's Health First Act (Dingell); H.R. 1663: Medicare Mental Health Modernization Act (Stark) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2147: Healthy Kids Act (Emanuel); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 401: Keep Children Covered Act (Rockefeller); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 895: Children's Health First Act (Clinton); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1224: Children's Health Insurance Program Reauthorization Act (Rockefeller); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. Con. Res. 70: Budget Resolution; (Conrad); H. Con. Res. 312: Budget Resolution, section 201 (Spratt). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, bidding and payment issues (including MA coding intensity, Part D reinsurance, and low income subsidies), benefit design rules, SSA and CMS premium withhold processing issues, systems issues affecting enrollment and disenrollment processing, enrollment rules, marketing materials review and approval, marketing activities, including conduct of brokers and agents and plan sponsor marketing staff and issues raised by CMS about Private Fee-for-Service (PFFS) plan marketing, measurement and oversight of plan performance including Special Needs Plans (SNPs), grievance and appeals processes, Medicare/Medicaid integration issues for Special Needs Plans (SNPs), Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval, systems issues affecting enrollment and disenrollment processing, payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting inititiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs) and federal matching funds for graduate medical education; coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

Client expense: $1,820,000 · 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), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of