Independence at Home Act of 2009

S 756, Prostate Research Imaging and Men's Education Act S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act HR 3652, Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy Act of 2009 S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S 1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Health Choices Act of 2009 S 1679, Affordable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Protection and Affordable Care Act HR 4872, Healthcare and Education Affordability Reconciliation Act of 2010 USPSTF Transparency HR 5461, Virtual Screening for Colorectal Cancer Act of 2010 HR 1213, Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 Labor, HHS Appropriations

Client expense: $15,460,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

S 756, Prostate Research Imaging and Men's Education Act S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act AAA Screening Legislation HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Health Choices Act of 2009 S 1679, Affordable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Medicare Coverage of CT Colonography Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Protection and Affordable Care Act HR 4872, Healthcare and Education Affordability Reconciliation Act of 2010 USPSTF Transparency

Client expense: $7,310,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services. No bill: Advocate to Congress and Centers for Medicare/Medicaid Services (CMS) to oppose proposed Medicare Physician Payment Reductions, cuts to therapy reimbursement in the proposed 2011 Medicare Physician Fee Schedule rule. CMS staff: Marilyn Tavenner, Principal Deputy Administrator and Johnathan Bluhm, Director of Center for Medicare Management HR 1586 - Education and Medicaid Funding for States: Supported passage.

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

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

H.R. 3590: the Patient Protection and Affordable Care Act H.R. 4872: the Health Care and Education Reconciliation Act of 2010 S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the trageting of the enforcement of requirements with respect to such facilities. S.1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older American with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: 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. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuing adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title of certain non-instutional full-benefit dual eligible individuals. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 4505: A bill that will allow state veterans homes to provide services to non-veteran parents of any child (one or more) who died while serving in the armed forces, has passed in the House and Senate. S. 1679: An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experiences health care professionals. S.1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. H.R. 2: To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. S. 795: A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.631: A bill to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 458: A bill to amend the False Claims Act. H.R. 2043: To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students, and for other purposes. H.R. 1642: To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 1494: To ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster. H.R. 448: To protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes. H.R. 3191: To amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes. S. 386: A bill to improve enforcement of mortgage fraud, securities fraud, financial institutional fraud, and other frauds related to federal assistance and relief programs, for the recovery of funds lost to these frauds, and for other purposes. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010. H.R. 6130: The Strengthening Medicare Anti-Fraud Measures Act of 2010. H.R. 6261: To amend titles XVIII and XIX of the Social Security Act to improve oversight of nursing facilities under the Medicare and Medicaid programs by ensuring adequate, trained surveyors, and for other purposes. H.R. 5712: Veterans', Seniors', Childrens', Health Tech. Corrections Act of 2010. H.R. 1586: FAA Air Transportation Modernization and Safety Improvement Act-which provides for an extension of additional FMAP support until June 2011. H.R. 6074: Enhancing Quality through Survey System Improvements Act of 2010. H.R. 5950: A bill introduced on June 29th, Rep Joe Courtney (D-CT), introduced the Improving Access to Medicare Coverage Act of 2010, which requires observation stays exceeding 24 hours to be considered as inpatient days for the purpose of meeting the 3-day inpatient hospital requirement for Medicare coverage of SNF stays. H.R. 5850: To solve the staffing issues and backlog in processing HUD 232 loans. H.R. 5950: Improving Access to Medicare Coverage Act of 2010. H.R. 5546: To provide for the establishment of a fraud, waste and abuse detection and mitigation program for the Medicare program under Titles XVIII of the Social Security Act. S. 2781: Rosa's Law. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010.

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE

S. 3015 (111th Congress)/H.R.3865 (110th Congress): The Home Health Care Access Protection Act - All sections S. 457/H.R. 3030: Fostering Independence Through Technology Act of 2009 -- All sections S. 1157: Craig Thomas Rural Hospital and Provider Equity Act -- sections 11, 14 and 18 S. 2814/H.R.4993: Home Health Care Planning Improvement Act -- All sections H.R. 2068, Medicare Telehealth Enhancement Act -- sections 104, 105, and 106 S. 1131/H.R. 2560: The Independence at Home Act -- All sections S. 1104/H.R. 2307: RE-Aligning Care Act -- All sections S. 421: Medicare Hospice Protection Act -- All sections S. 631: The Patient Safety and Abuse Prevention Act of 2009 -- All sections S. 1123: The Medicare Rural Home Health Preservation Act All sections H.R.3790: (Bill to repeal competitive acquisition program for DME) All sections S.3000: (Bill to extend Medicaid FMAP for six months) All sections H.R.4263: State Medicaid Assistance Extension Act of 2009 All sections H.R. 1: American Recovery and Reinvestment Act of 2009 Sections relating to technology

Client expense: $320,000 · Firm income: Not reported

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

S 756, Prostate Research Imaging and Men's Education Act S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act HR 3652, Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy Act of 2009 S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S 1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Health Choices Act of 2009 S 1679, Affordable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Protection and Affordable Care Act HR 4872, Healthcare and Education Affordability Reconciliation Act of 2010 USPSTF Transparency HR 5461, Virtual Screening for Colorectal Cancer Act of 2010 HR 1213, Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 Labor, HHS Appropriations

Client expense: $8,300,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

H.R. 3590: the Patient Protection and Affordable Care Act H.R. 4872: the Health Care and Education Reconciliation Act of 2010 S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the trageting of the enforcement of requirements with respect to such facilities. S.1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure ofr delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older American with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: 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. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuing adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute edler abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title of certain non-instutional full-benefit dual eligible individuals. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679: An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experiences health care professionals. S.1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. H.R. 2: To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. S. 795: A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.631: A bill to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 458: A bill to amend the False Claims Act. H.R. 2043: To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students, and for other purposes. H.R. 1642: To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 1494: To ensure that a private for-profit nursing home affected by a major disaster receives the same rreimbursement as a public nursing home affected by a major disaster. H.R. 448: To protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes. H.R. 3191: To amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes. S. 386: A bill to improve enforcement of mortgage fraud, securities fraud, financial institutional fraud, and other frauds related to federal assistance and relief programs, for the recovery of funds lost to these frauds, and for other purposes. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010.

Client expense: $480,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR4691 (PL 111-144) - Temporary Extensions Act of 2010: Advocate for extension of Medicare Therapy Caps Exceptions process and the Medicare Physicians Payment Update. HR 4851 (PL 111-157) - Continuing Extension Act of 2010: Advocate for extension of Medicare Physicians Payment Update. HR 3692 (PL 111-192) - Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010: Advocated for extension of Medicare Physicians Payment Update. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services.

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

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 3015 (111th Congress)/H.R.3865 (110th Congress): The Home Health Care Access Protection Act - All sections S. 457/H.R. 3030: Fostering Independence Through Technology Act of 2009 -- All sections S. 1157: Craig Thomas Rural Hospital and Provider Equity Act -- sections 11, 14 and 18 S. 2814/H.R.4993: Home Health Care Planning Improvement Act -- All sections H.R. 2068, Medicare Telehealth Enhancement Act -- sections 104, 105, and 106 S. 1131/H.R. 2560: The Independence at Home Act -- All sections S. 1104/H.R. 2307: RE-Aligning Care Act -- All sections S. 421: Medicare Hospice Protection Act -- All sections S. 631: The Patient Safety and Abuse Prevention Act of 2009 -- All sections S. 1123: The Medicare Rural Home Health Preservation Act All sections H.R.3790: (Bill to repeal competitive acquisition program for DME) All sections S.3000: (Bill to extend Medicaid FMAP for six months) All sections H.R.4263: State Medicaid Assistance Extension Act of 2009 All sections

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

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

HR 3590 Patient Protection and Affordable Care Act HR 2866/S 1674 Iproving Access to Clinical Trials Act HR 2560.S 1131 Independence at Home Act HR 4272/S 1206 Pediatric Workforce Investment Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 756, Prostate Research Imaging and Men's Education Act S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act AAA Screening Legislation HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Health Choices Act of 2009 S 1679, Affordable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Medicare Coverage of CT Colonography Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Protection and Affordable Care Act HR 4872, Healthcare and Education Affordability Reconciliation Act of 2010 USPSTF Transparency

Client expense: $7,140,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. S. 1679 - Affordable Health Choices Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and support of efforts to address shortages in health care workforce, including occupational therapy.. S. 1796 - America's Healthy Future Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR4691 (PL 111-144) - Temporary Extensions Act of 2010: Advocate for extension of Medicare Therapy Caps Exceptions process and the Medicare Physicians Payment Update. HR 4851 (PL 111-157) - Continuing Extension Act of 2010: Advocate for extension of Medicare Physicians Payment Update.

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

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 2718/S 1110 - MedPAC Reform Act of 2009 HR 2307/S 1004 - Reaching Elders with Assessment and Chronic Care Management and Coordination Act Under Line 17: We would like to include the Dept of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) and the Office of Inspector General (OIG) S 1634 - The Medicare Prescription Drug Improvement Act of 2009 S 266 - Medicare Prescription Drug Gap Reduction Act of 2009 HR 203 - Medicare Fraud Prevention Act of 2009 HR 27 - Medicare Fraud Prevention and Enforcement Act of 2009 HR 616/S 511 - Access to Durable Medical Equipment Act HR 574/S 254 - Medicare Home Infusion Therapy Coverage Act of 2009 HR 2560/S 1131 - Independence At Home Act HR 1970/S 956 - Preserve Patient Access to the Reputable DMEPOS Providers Act of 2009 HR 3700/S 1951 - Fair Medicaid Drug Payment Act (From 110th Congress)/Concept to Include Medicaid Average Manufacturers Price Reimbursement Formula in Health Care Reform HR 3108 - Medication Therapy Management Benefits Act of 2009/Concept to Include Medication Therapy Management Provisions in Health Care Reform S 683 - Community Choice Act of 2009 HR 1392/S 1221 - Amends the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under Part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price S AMDT 3320 to the Commerce, Justice, Science, and Related Agencies Appropriations Act, 2010 (H.R.2847) [Section on the treatment of pharmacies under durable medical equipment accreditation requirements] (Public Law 110-275) Medicare Improvements for Patients and Providers Act of 2008 sections on Medicare DMEPOS (Docket Number CMS-4085-P) Medicare Program; Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs (Docket Number: CMS1561IFC) Medicare Program; Changes to the Competitive Acquisition of Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) by Certain Provisions of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Docket Number: CMS-1540-F) Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2007; Certain Provisions Concerning Competitive Acquisition for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS); Accreditation of DMEPOS Suppliers (Docket Number: CMS-6006-F) Medicare Program: Surety Bond Requirement for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) (Docket Number: CMS-0033-P) Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Proposed Rule (Docket Number: RIN 0991-AB58) Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology (Docket Number: RIN 0991AB59) Proposed Establishment of Certification Programs for Health Information Technology (74 FR 28937) ONC Draft Recommendations for the Term "Meaningful Use" of Electronic Health Records CMS August 2009 Memo: Fraud, Waste and Abuse (FWA) Training Clarification (regarding changes to 42 C.F.R. 422.503(b)(4)(vi) and 42 C.F.R. 423.504 (b)(4)(vi)) Final 2010 Medicare Part D Call Letter on NDC Non-Matched List 2011 Preliminary Advanced Notice with Draft Call Letter to Medicare Plans 2011 Preliminary Advanced Notice with Final Call Letter to Medicare Plans Draft Medicare Part D Model Notices for Beneficiaries: Mail-Order and Excluded Provider GAO Report on Medicaid Outpatient Prescription Drugs: Second Quarter 2008 Federal Upper Limits for Reimbursement Compared with Average Retail Pharmacy Acquisition Costs OIG Report on A Comparison of Medicaid Federal Upper Limit Amounts to Acquisition Costs, Medicare Payment Amounts, and Retail Prices

Client expense: $149,615 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

H.R. 2560/S. 1131; Independence at Home Act of 2009. Provisions in Health Care Reform related to nursing and nurse led models of care. H.R. 1101/S. 662; The Midwifery Care Access and Reimbursement Equity Act. Provisions in Health Care Reform related to reimbursement for certified nurse midwives.. S. 54; Registered Nurse Safe Staffing Act of 2009 S. 63; Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2009. H.R. 3185/S. 1569; Medicare Graduate Nursing Education Act. H.R. 684/S. 330; Medicare Prescription Drug Savings and Choice Act of 2009. Provisions related to Advanced Practic Nurses and Registered nurses related to general health care reform initiatives. H.R. 3590; Patient Protection and Affordable Care Act. Provisions related to medical underwriting. H.R. 3200; Affordable Health Choices Act of 2009 Provisions related to affordability and privacy, health care disparities, and graduate nurse education. S. 1796; America's Healthy Future Act Provisions related to health care and nursing. SA 2908; "Support for Family Caregivers Under Medicare and Medicaid" S. 1776; Medicare Physician Fairness Act of 2009 Provisions related to the sustainable growth rate formula in medicare. H.R. 3962; Affordable Health Care for America Act. Provisions related to mental health and addiction, prevention, treatment and recovery and support services, and all other health care provisions. Provisions in HCR which would encourage the formation of health care choice compacts. Provisions related to payment rate for primary care services to equal the payment rate for Medicare. H.R. 4872 The Health Care and Education Affordability Reconciliation Act.

Client expense: $327,083 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and provisions included in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation in healthcare reform on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reduce wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). S.750 Caring for an Aging America Act - Discussed as possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation to make improvements in the Patient Protection and Affordable Care Act. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/ S.1796, America's Healthy Future Act - Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments.

Client expense: $3,970,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and provisions included in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation in healthcare reform on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reduce wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). S.750 Caring for an Aging America Act - Discussed as possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation to make improvements in the Patient Protection and Affordable Care Act. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/ S.1796, America's Healthy Future Act - Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments.

Client expense: $3,970,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Physician reimbursement rates; Health IT Provisions; Medicare Medical Home Issues; S. 53, the Nursing School Clinics Act of 2009; S. 63, the Medicaid Advanced Practice Nurses & Physician Assistants Act of 2009; H.R. 2754/S. 1104 - Graduate Nursing Education Issues; Nurse Managed Health Clinic Investment Act; S. 1131/H.R. 2560 - the Independence at Home Act; H.R. 3590, the Patient Protection and Affordable Care Act; S. 1679, Affordable Care Choices Act; S. 2814 - Home Health Care Planning Improvememt Act of 2009; H.R. 3962, the Affordable Health Care for America Act; H.R. 3780, Health Care Reform Provisions; H.R. 3961, Medicare Physician Payment Reform Act, Sustainable Growth Rate Issues; H.R. 4872, the Health Care and Education Reconciliation Act of 2010; The Patient Protection & Affordable Care Act (P.L. 111-148).

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

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

HR 3200 America's Affordable Health Choices Act of 2009 S 1796, America's Healthy Future Act of 2009, provisions relating to the chairman's mark S 1679 The Affordable Health Choices Act HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 4872 Health Care and Education Reconciliation Act of 2010 HR 2560 Independence at Home Act of 2009 S 1131 Independence at Home Act of 2009 HR 3688 To encourage programs of health promotion or disease prevention HR 3472 To provide for health insurance coverage premium discounts for healthy behavior and improvements toward behavior HR 1548 Pathway for Biosimilars Act S 1110 Medicare Payment Advisory Commission (MedPac) Reform Act of 2009 HR 2718 Medicare Payment Advisory Commission (MedPac) Reform Act of 2009 S 1156 Safe Routes to School Program Reauthorization Act HR 1585 FIT Kids Act S 634 FIT Kids Act HR 1342 The Child Nutrition Promotion and School Lunch Protection Act S 934 The Child Nutrition Promotion and School Lunch Protection Act HR 2105 The Personal Health Investment Today Act HR 2276 The Improved Nutrition and Physical Activity Act S 1060 Obesity Prevention, Treatment, and Research Act S 803 Healthy Workforce Act of 2009 HR 1897 Healthy Workforce Act of 2009

Client expense: $248,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 3590: the Patient Protection and Affordable Care Act H.R. 4872: the Health Care and Education Reconciliation Act of 2010 S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the trageting of the enforcement of requirements with respect to such facilities. S.1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure ofr delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older American with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: 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. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuing adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute edler abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title of certain non-instutional full-benefit dual eligible individuals. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679: An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experiences health care professionals. S.1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. H.R. 2: To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. S. 795: A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.631: A bill to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 458: A bill to amend the False Claims Act. H.R. 2043: To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students, and for other purposes. H.R. 1642: To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 1494: To ensure that a private for-profit nursing home affected by a major disaster receives the same rreimbursement as a public nursing home affected by a major disaster. H.R. 448: To protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes. H.R. 3191: To amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes. S. 386: A bill to improve enforcement of mortgage fraud, securities fraud, financial institutional fraud, and other frauds related to federal assistance and relief programs, for the recovery of funds lost to these frauds, and for other purposes.

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Part C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio for insurance premiums, inclusion of patient-centered quality reporting requirements for providers, creating new claims reviews processes and provider certification, requiring reporting by practitioners of gifts received from pharmaceutical and medical device manufacturers. Medicare/Commission. P.L. 111-148, P.L. 111-152, H.R. 4872: creating an independent commission authorized to establish Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330, H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. P.L. 111-148, P.L. 111-152, H.R. 4872, S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 27: relating to provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 43, S. 46: repealing or extending exceptions to outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authorizing coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894, S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1407, S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700, H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458, S. 565: provision related to continued coverage for immunosuppressive drugs furnished to beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765, S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574, S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 1131, H.R. 2560: provisions establishing pilot care coordination programs. Medicaid/Home and Community-based Long Term Care. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid. P.L. 110-275, P.L. 108-173: implementation of regulations and guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and appeals processes under Medicare Parts C and D.

Client expense: $350,000 · Firm income: Not reported

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

S. 2181/H.R.3865 (110th Congress): The Home Health Care Access Protection Act - All sections S. 457/H.R. 3030: Fostering Independence Through Technology Act of 2009 -- All sections S. 1157: Craig Thomas Rural Hospital and Provider Equity Act -- sections 11, 14 and 18 S. 2814: Home Health Care Planning Improvement Act of 2009 -- All sections H.R. 2068, Medicare Telehealth Enhancement Act -- sections 104, 105, and 106 S. 1131/H.R. 2560: The Independence at Home Act -- All sections S. 1104/H.R. 2307: RE-Aligning Care Act -- All sections S. 421: Medicare Hospice Protection Act -- All sections S. 631: The Patient Safety and Abuse Prevention Act of 2009 -- All sections S. 1123: The Medicare Rural Home Health Preservation Act All sections

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

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

S 756, Prostate Research Imaging and Men's Education Act HR 1, American Recovery and Reinvestment Act : HR 2346, S336, S1054, Supplemental Appropriations, FY 2009 S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act AAA Screening Legislation HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Healtth Choices Act of 2009 S 1679, Affodable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Medicare Coverage of CT Colonography Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Perfection and Affordable Care Act

Client expense: $7,350,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

S 756, Prostate Research Imaging and Men's Education Act HR 1, American Recovery and Reinvestment Act : HR 2346, S336, S1054, Supplemental Appropriations S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act AAA Screening Legislation HR 3138 Physician Payments Sunshine Act HR 2502, comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Healtth Choices Act of 2009 S 1679, Affodable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Medicare Coverage of CT Colonography Health Information Technology Healthcare Reform MedPAC Reform

Client expense: $7,060,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Senate Finance Committee Draft Policy Options (Baucus/Grassley) - expanded care coordination services in Medicaid, promotion of prevention and wellness in Medicare and Medicaid, health disparaties, quality improvements, health information technology House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) - sections 1176-1179 Medicare Advantage special needs plans, section 1301 Medicare Accountable Care Organization Pilot Program, section 1302 Medicare Medical Home pilot program Medicare Transitional Care Act of 2009 - HR 2773 (Blumenauer)/S 1295 (Bennet) - entire bill RE-Aligning Care Act - HR 2307 (Green)/S 1004 (Lincoln) - entire bill Independence At Home Act of 2009 - HR 2560 (Markey)/S 1131 (Wyden) - entire bill

Client expense: $173,000 · Firm income: Not reported

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

Senate Finance Committee Draft Policy Options (Baucus/Grassley) - expanded care coordination services in Medicaid, promotion of prevention and wellness in Medicare and Medicaid, health disparaties, quality improvements, health information technology House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) - sections 1176-1179 Medicare Advantage special needs plans, section 1301 Medicare Accountable Care Organization Pilot Program, section 1302 Medicare Medical Home pilot program Medicare Transitional Care Act of 2009 - HR 2773 (Blumenauer)/S 1295 (Bennet) - entire bill RE-Aligning Care Act - HR 2307 (Green)/S 1004 (Lincoln) - entire bill Independence At Home Act of 2009 - HR 2560 (Markey)/S 1131 (Wyden) - entire bill

Client expense: $173,000 · Firm income: Not reported

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

S 756, Prostate Research Imaging and Men's Education Act HR 1, American Recovery and Reinvestment Act : HR 2346, S336, S1054, Supplemental Appropriations, FY 2009 S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act AAA Screening Legislation HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Healtth Choices Act of 2009 S 1679, Affodable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Medicare Coverage of CT Colonography Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Perfection and Affordable Care Act

Client expense: $6,840,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Lobbied in favor of the Senate Patient Protection and Affordable Care Act, the combined Senate-House health reform bill, and specifically for inclusion of the following provisions and amendments: S. 647 and House language for the "Nursing Home Transparancy and Improvement Act of 2009;" Senate Wellness Exam for Medicare benficiaries and provision on "detection of any cognitive impairment;" S. 245 and H.R. 468, "Retooling the Health Care Workforce;" as well as specific provisions from the bill on direct care training; S. 697 and H.R. 1721, Community Living Assistance Services and Supports (CLASS) Act;" S. 1131 and H.R. 2560, The Independence at Home Act; S. 795, "Elder Justice Act;" and S. 631, "Patient Safety and Abuse Prevention Act." Also lobbied in favor of the following amendments to the Senate health reform bill: Clinical trials amendment (Brown, 2871) Support for family caregivers under Medicare and Medicaid (Klobuchar 2908) Priorities for the National Health Care Workforce Commission (Casey 2928) Growing Geriatric Care Workforce (Boxer 2944) Improve Consumer Protections for Long-Term Care (Kohl 2996) Improves Medicare reimbursement to Primary Care (Klobuchar 2997) Also lobbied for a Senate sponsor for the Alzheimer's Treatment and Caregiver Support Act, S. 2809; for introduction and support of National Memory Screening Day resolutions (S.Res.185 and H.Res.910); and for co-sponsors for H.R. 3043, the Medicare Adult Day Care Services Act of 2009" and its inclusion in health reform.

Client expense: $22,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and including provisions in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation and amendment on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and urged it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population age rating and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - To let Americans aged 55-64 who are otherwise without access to grup or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). H.R. 3293, Labor, HHS, Education and related agencies Appropriations bill for FY2010-Lobbied for funding for SSA, Older Americans Act programs, Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act). S.750 Caring for an Aging America Act - Discussed possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act, America's Healthy Future Act (no Senate bill)- Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. S. 2926, Economic Fairness for Seniors Act - Discussed legislation that would allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries, provide social security beneficiaries with $250 in economic relief in response to the lack of cost of living adjustment for 2010, and convert from the CPI-W to the CPI-E. H.J.Res. 64, Third Continuing Resolution, FY 2010; not enacted - Lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. H.R. 3326, Division B, Defense Appropriations bill for FY 2010 - Lobbied for SNAP participation changes, extension of unemployment benefits and COBRA eligibility, delay in cuts to Medicare physician payments. H.R. 2996, Division B, Interior Appropriations bill lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico seniors in Medicare Part B. (no bill) Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico and the territories, and the auto-enrollment of Puerto Rico seniors in Medicare Part B. (no bill)

Client expense: $5,950,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and including provisions in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation and amendment on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and urged it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population age rating and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - To let Americans aged 55-64 who are otherwise without access to grup or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). H.R. 3293, Labor, HHS, Education and related agencies Appropriations bill for FY2010-Lobbied for funding for SSA, Older Americans Act programs, Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act). S.750 Caring for an Aging America Act - Discussed possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act, America's Healthy Future Act (no Senate bill)- Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. S. 2926, Economic Fairness for Seniors Act - Discussed legislation that would allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries, provide social security beneficiaries with $250 in economic relief in response to the lack of cost of living adjustment for 2010, and convert from the CPI-W to the CPI-E. H.J.Res. 64, Third Continuing Resolution, FY 2010; not enacted - Lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. H.R. 3326, Division B, Defense Appropriations bill for FY 2010 - Lobbied for SNAP participation changes, extension of unemployment benefits and COBRA eligibility, delay in cuts to Medicare physician payments. H.R. 2996, Division B, Interior Appropriations bill lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico seniors in Medicare Part B. (no bill) Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico and the territories, and the auto-enrollment of Puerto Rico seniors in Medicare Part B. (no bill)

Client expense: $5,950,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 2560/S. 1131; Independence at Home Act of 2009. Provisions in Health Care Reform related to nursing and nure led models of care. H.R. 1101/S. 662; The Midwifery Care Access and Reimbursement Equity Act. Provisions in Health Care Reform related to reimbursement for certified nurse midwives.. S. 54; Registered Nurse Safe Staffing Act of 2009 S. 63; Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2009. H.R. 3185/S. 1569; Medicare Graduate Nursing Education Act. H.R. 684/S. 330; Medicare Prescription Drug Savings and Choice Act of 2009. Provisions related to Advanced Practic Nurses and Registered nurses related to general health care reform initiatives. H.R. 3590; Patient Protection and Affordable Care Act. Provisions related to medical underwriting. H.R. 3200; Affordable Health Choices Act of 2009 Provisions related to affordability and privacy, health care disparities, and graduate nurse education. S. 1796; America's Healthy Future Act Provisions related to health care and nursing. SA 2908; "Support for Family Caregivers Under Medicare and Medicaid" S. 1776; Medicare Physician Fairness Act of 2009 Provisions related to the sustainable growth rate formula in medicare. H.R. 3962; Affordable Health Care for America Act. Provisions related to mental health and addiction, prevention, treatment and recovery serices, and all other health care provisions.

Client expense: $376,632 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 2718/S 1110 - MedPAC Reform Act of 2009 HR 2307/S 1004 - Reaching Elders with Assessment and Chronic Care Management and Coordination Act S 1634 - The Medicare Prescription Drug Improvement Act of 2009 Under Line 17: We would like to include the Office of the National Coordinator for Health Information Technology S 266 - Medicare Prescription Drug Gap Reduction Act of 2009 HR 203 - Medicare Fraud Prevention Act of 2009 HR 27 - Medicare Fraud Prevention and Enforcement Act of 2009 HR 616/S 511 - Access to Durable Medical Equipment Act HR 574/S 254 - Medicare Home Infusion Therapy Coverage Act of 2009 HR 2560/S 1131 - Independence At Home Act HR 1970/S 956 - Preserve Patient Access to the Reputable DMEPOS Providers Act of 2009 HR 3700/S 1951 - Fair Medicaid Drug Payment Act (From 110th Congress)/Concept to Include Medicaid Average Manufacturers Price Reimbursement Formula in Health Care Reform HR 3108 - Medication Therapy Managament Benefits Act of 2009/Concept to Include Medication Therapy Management Provisions in Health Care Reform HR 3663 - Amends the Social Security Act to delay the October 1, 2009 deadline on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies. (Public Law 111-72) S 683 - Community Choice Act of 2009 HR 1392/S 1221 - Amends the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under Part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price (Public Law 110-275) Medicare Improvements for Patients and Providers Act of 2008 sections on Medicare DMEPOS (Docket Number CMS-4085-P) Medicare Program; Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs (Docket Number: CMS1561IFC) Medicare Program; Changes to the Competitive Acquisition of Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) by Certain Provisions of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Docket Number: CMS-1540-F) Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2007; Certain Provisions Concerning Competitive Acquisition for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS); Accreditation of DMEPOS Suppliers (Docket Number: CMS-6006-F) Medicare Program: Surety Bond Requirement for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) (Docket No. CMS-4085-P) Medicare Program; Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs Docket Number: CMS-10260 (OMB#: 0938-1051) Collection Activities; Medicare Advantage and Prescription Drug Program: Final Marketing Provisions (74 FR 28937) ONC Draft Recommendations for the Term "Meaningful Use" of Electronic Health Records CMS August 2009 Memo: Fraud, Waste and Abuse (FWA) Training Clarification (regarding changes to 42 C.F.R. 422.503(b)(4)(vi) and 42 C.F.R. 423.504 (b)(4)(vi)) Final 2010 Medicare Part D Call Letter Draft Part D Model Notices for Beneficiaries: Mail-Order and Excluded Provider

Client expense: $117,517 · Firm income: Not reported

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

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. S. 1679 - Affordable Health Choices Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and support of efforts to address shortages in health care workforce, including occupational therapy.. S. 1796 - America's Healthy Future Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy.

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

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 2181/H.R.3865 (110th Congress): The Home Health Care Access Protection Act - All sections S. 457/H.R. 3030: Fostering Independence Through Technology Act of 2009 -- All sections S. 1157: Craig Thomas Rural Hospital and Provider Equity Act -- sections 11, 14 and 18 S. 2814: Home Health Care Planning Improvement Act of 2009 -- All sections H.R. 2068, Medicare Telehealth Enhancement Act -- sections 104, 105, and 106 S. 1131/H.R. 2560: The Independence at Home Act -- All sections S. 1104/H.R. 2307: RE-Aligning Care Act -- All sections S. 421: Medicare Hospice Protection Act -- All sections S. 631: The Patient Safety and Abuse Prevention Act of 2009 -- All sections S. 1123: The Medicare Rural Home Health Preservation Act All sections

Client expense: $270,000 · Firm income: Not reported

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

Physician reimbursement rates; Health IT Provisions; Medicare Medical Home Issues; Home Health Reimbursement Issues; S. 53, the Nursing School Clinics Act of 2009; S. 63, the Medicaid Advanced Practice Nurses & Physician Assistants Act of 2009; H.R. 2754/S. 1104 - Graduate Nursing Education Issues; Nurse Managed Health Clinic Investment Act; S. 1131/H.R. 2560 - the Independence at Home Act; H.R. 3590, the Patient Protection and Affordable Care Act; S. 1679, Affordable Care Choices Act; H.R. 3962, the Affordable Health Care for America Act; H.R. 3780, Health Care Reform Provisions; H.R. 3961, Medicare Physician Payment Reform Act, Sustainable Growth Rate Issues.

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

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

H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S. 1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill 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. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: 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. H.R. 1: Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes. H.R. 2: The Children's Health Insurance Program Reauthorization Act of 2009, establishing a Medicaid and CHIP Payment and Access Commission (MACPAC). This new Commission will provide Congress with a new, credible forum to discuss specific ways to strengthen the nation's Medicaid payment system, and ensure the growing needs of America's most vulnerable, frail, elderly and the disabled beneficiaries are met and in the years ahead. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 1255: A bill which protects the interests of each resident of intermediate care facilities for the mentally retarded or developmentally disabled (ICFs/MRDD) in related class action lawsuits. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796: America's Healthy Future Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 632: To encourage, enhance, and integrate Silver Alert plans throughout the United States, to authorize grants for the assistance of organizations to find missing adults, and for other purpose. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experienced health care professionals. S. 1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 632: To encourage, enhance, and integrate Silver Alert plans throughout the United States, to authorize grants for the assistance of organizations to find missing adults, and for other purposes. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3191: To amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 3590: The Patient Protection and Affordable Care Act. S. 1679 An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers.

Client expense: $440,000 · Firm income: Not reported

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

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. H.R. 3590, H.R. 3962, H.R. 3200, S. 1679: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Part C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio for insurance premiums, inclusion of patient-centered quality reporting requirements for providers, creating new claims reviews processes and provider certification, requiring reporting by practitioners of gifts received from pharmaceutical and medical device manufacturers. Medicare/Commission. S. 1110 and S. 1380: authorizing an enhanced MedPAC as an executive branch commission with authority to implement Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43/S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authoring coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407/S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700/H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458/S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765/S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574/S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program.

Client expense: $340,000 · Firm income: Not reported

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

HR 3200; HR3590; Amendments 3136; S1131; HR2560 ARRA - EHR and meaningful use National Broadband Plan regarding healthcare

Client expense: $1,030,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Education, Dept of, Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Intl Trade Administration (ITA), SENATE, State, Dept of (DOS), U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR)

Healthcare - HR 3200; HR 2068I; S 1131; HR 2560; Senate Finance America's Health Future Act; Senate HELP's Affordable Health Choices Act

Client expense: $1,110,260 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Intl Trade Administration (ITA), Natl Economic Council (NEC), Natl Security Agency (NSA), SENATE, Small Business Administration (SBA), U.S. Trade Representative (USTR)

H.R. 2560/S. 1131; Independence at Home Act of 2009. H.R. 1101/S. 662; The Midwifery Care Access and Reimbursement Equity Act. H.R. 2773/S.1295; The Medicare Transitional Care Act S. 54; Registered Nurse Safe Staffing Act of 2009 S. 63; Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2009. H.R. 3185/S. 1569; Medicare Graduate Nursing Education Act. H.R. 684/S. 330; Medicare Prescription Drug Savings and Choice Act of 2009. Provisions related to Advanced Practic Nurses and Registered nurses in general health care reform initiatives. Provisions related to the public plan option in health care reform initiatives. Provisions related to quality in health care reform initiatives.

Client expense: $443,250 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3200 America's Affordable Health Choices Act of 2009 S 1679 Affordable Health Choices Act HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009 HR 1321 Healthy Americans Act S 803 Healthy Workforce Act of 2009 HR 1897 Healthy Workforce Act of 2009 S 726 Promoting Innovation and Access to Life-Saving Medicine Act HR 1427 Promoting Innovation and Access to Life-Saving Medicine Act S 979 Small Business Health Options Program Act of 2009 HR 2360 Small Business Health Options Program Act of 2009 HR 2520 Patients' Choice Act S 1099 Patients' Choice Act HR 2427 Informed Consumer Choices in Health Care Act of 2009 S 1050 Informed Consumer Choices in Health Care Act of 2009 HR 2502 Comparative Effectiveness Research Act of 2009 HR 2560 Independence at Home Act of 2009 S 1131 Independence at Home Act of 2009 HR 2252 National Health Care Quality Act S 966 National Health Care Quality Act S 1060 Obesity Prevention, Treatment, and Research Act of 2009 S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S 1114 Medical Homes Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1278 Consumers Health Care Act of 2009 HR 1691 Breast Cancer Patient Protection Act of 2009 S 688 Breast Cancer Patient Protection Act of 2009 HR 1558 Preexisting Condition Patient Protection Act of 2009 S 623 Pre-existing Condition Patient Protection Act of 2009 HR 1619 Children's Health Protection Act of 2009 S 643 Children's Health Protection Act of 2009 HR 1092 No Discrimination in Health Insurance Act of 2009 HR 2427 Informed Consumer Choices in Health Care Act of 2009 S 1050 Informed Consumer Choices in Health Care Act of 2009 HR 1321 Healthy Americans Act S 391 Healthy Americans Act HR 3688 To encourage programs of health promotion or disease prevention HR 3472 To provide for health insurance coverage premium discounts for healthy behavior and improvements toward behavior HR 1548 Pathway for Biosimilars Act S 1156 Safe Routes to School Program Reauthorization Act

Client expense: $900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE, White House Office

S 756, Prostate Research Imaging and Men's Education Act HR 1, American Recovery and Reinvestment Act : HR 2346, S336, S1054, Supplemental Appropriations S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act AAA Screening Legislation HR 3138 Physician Payments Sunshine Act HR 2502, comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Healtth Choices Act of 2009 S 1679, Affodable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Medicare Coverage of CT Colonography Health Information Technology Healthcare Reform MedPAC Reform

Client expense: $6,940,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

S. 1110 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S. 1040 - Seniors' Medication Copayment Reduction Act of 2009 S. 1679 - Affordable Health Choices Act S. 1131 - Independence at Home Act of 2009 HR 3200: America's Affordable Health Choices Act of 2009 Senate Finance Committee Version: America's Healthy Future Act of 2009

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

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

S. 2181/H.R.3865 (110th Congress): The Home Health Care Access Protection Act - All sections S. 457: Fostering Independence Through Technology Act of 2009 -- All sections S. 1157: Craig Thomas Rural Hospital and Provider Equity Act -- sections 11, 14 and 18 S. 1678 (110th Congress): Home Health Care Planning Improvement Act of 2007 -- All sections H.R. 2068, Medicare Telehealth Enhancement Act -- sections 104, 105, and 106 S. 1131/H.R. 2560: The Independence at Home Act -- All sections S. 1104/H.R. 2307: RE-Aligning Care Act -- All sections S. 421: Medicare Hospice Protection Act -- All sections S. 631: The Patient Safety and Abuse Prevention Act of 2009 -- All sections S. 1123: The Medicare Rural Home Health Preservation Act All sections S. 697/H.R. 1721 Community Living Assistance Services and Supports (CLASS Act) All sections H.R. 3200/Americas Healthy Future Act (draft legislation) -- Senate and House -- sections related to home health, hospice, and fraud and abuse

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

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

Physician reimbursement rates; Health IT Provisions; Medicare Medical Home Issues; Home Health Reimbursement Issues; S. 53, the Nursing School Clinics Act of 2009; S. 63, the Medicaid Advanced Practice Nurses & Physician Assistants Act of 2009; H.R. 2754/S. 1104 - Graduate Nursing Education Issues; Nurse Managed Health Clinic Investment Act; S. 1131/H.R. 2560 - the Independence at Home Act;

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

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

House Tri-Committee "America's Affordable Health Choices Act of 2009" (Waxman, Rangel and Miller - HR 3200) - Medicare Advantage reforms (subtitle D), accountable care organization pilot program (sec. 1301), medical home pilot program (sec. 1302), coverage and waiver of cost-sharing for preventive services (sec. 1305), required coverage of preventive services (Title VII, subtitle B, sec. 1711), Medicaid medical home pilot program (Title VII, subtitle C, sec. 1722). Senate Finance Chairman's Mark "America's Healthy Future Act of 2009" (no bill number) - promoting prevention and wellness in Medicare and Medicaid (Title II, subtitles A and B), improving quality and efficiency (Title III, subtitle A), encouraging development of new patient care models - accountable care organizations & CMS Innovation Center (Title III, part III), Medicare Advantage reform (Title III, subtitle C), patient-centered outcomes research (Title III, subtitle F). Medicare Transitional Care Act of 2009 - HR 2773 (Blumenauer)/S. 1295 Bennet) - entire bill RE-Aligning Care Act - HR 2307 (Green)/S 1004 (Lincoln) - entire bill Independence At Home Act of 2009 - HR 2560 (Markey)/S 1131 (Wyden) - entire bill

Client expense: $150,183 · Firm income: Not reported

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