Advance Planning and Compassionate Care Act of 2009

S. 465, Advance Directive Improvement and Education Act [Sen. Nelson (FL)] to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. Advocating for introduction of Comprehensive LGBT Aging legislation [Rep. Baldwin]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Long-Term Care S. 683/ H.R. 1670 - The Community Choice Act of 2009 H.R. 2516 - Medical Rights Act S.1150 - Advance Planning and Compassionate Care Act of 2009 H.R. 2520 - Patients' Choice Act H.R. 463/ S. 21 - Prevention First Act of 2009 Health Care Reform Implementation

Client expense: $57,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Employment & Training Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

Urged the Food and Drug Administration to issue a proposed rule immediately that establishes a unique device identification (UDI) system that supports both national and global needs through the GS1 system. H.R.3590/PL 111-148: Patient Protection and Affordable Care Act of 2010 - Advocated on the implementation of new health reform laws that will improve access to health coverage; including provisions specific to older adults, the Pregnancy Assistance Fund, delivery system reform and Medicaid. H.R. 4872/PL111-152: Health Care and Education Reconciliation Act of 2010 - Advocated for implementation in conjuction with H.R. 3590 Patient Protection and Affordable Care Act of 2010 S. 1150 - Advance Care Planning & Compassionate Care Act of 2009 - A bill to improve end of life care

Client expense: Not reported · Firm income: Not reported

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

S. 465, Advance Directive Improvement and Education Act [Sen. Nelson (FL)] to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. Advocating for introduction of Comprehensive LGBT Aging legislation [Rep. Baldwin]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 465, Advance Directive Improvement and Education Act [Sen. Nelson (FL)] to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. Advocating for introduction of Comprehensive LGBT Aging legislation [Rep. Baldwin]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Long-Term Care S. 683/ H.R. 1670 - The Community Choice Act of 2009 H.R. 2516 - Medical Rights Act S.1150 - Advance Planning and Compassionate Care Act of 2009 H.R. 2520 - Patients' Choice Act H.R. 463/ S. 21 - Prevention First Act of 2009 Health Care Reform Implementation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

S. 465, Advance Directive Improvement and Education Act [Sen. Nelson (FL)] to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.3590: Patient Protection and Affordable Care Act of 2010 - Advocated on the implementation of new health reform laws that will improve access to health coverage; including provisions specific to older adults, the Pregnancy Assistance Fund, delivery system reform and Medicaid. H.R. 4872: Health Care and Education Reconciliation Act of 2010 - Advocated for implementation in conjuction with H.R. 3590 Patient Protection and Affordable Care Act of 2010 Health Reform - Advocated to provide affordable health care coverage for all, protect and improve the Medicaid safety net, ensure hospital payment reductions coincide with coverage increases, preserve provider conscience protections & maintain current law on abortion, maintain consistency in requirements for charitable hospitals, and narrow the Medicare hospital readmissions policy & support delivery system reforms to improve quality of care. S. 1150 - Advance Care Planning & Compassionate Care Act of 2009 - A bill to improve end of life care Toxic Substance Control Act Advocating for strengthening the nations chemical regualtory system to limit chemical exposure to prevent disease and protect health.

Client expense: $150,000 · Firm income: Not reported

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

Long-Term Care S. 683/ H.R. 1670 - The Community Choice Act of 2009 H.R. 2516 - Medical Rights Act S.1150 - Advance Planning and Compassionate Care Act of 2009 H.R. 2520 - Patients' Choice Act H.R. 463/ S. 21 - Prevention First Act of 2009

Client expense: $67,500 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

H.R.3590:Patient Protection and Affordable Care Act of 2010 - Adovacted for comprehensive health reform legislation. H.R. 4872: Health Care and Education Reconciliation Act of 2010 - Advocated for legislative fixes in conjuction with H.R. 3590 Patient Protection and Affordable Care Act of 2010 H.R. 3962: Affordable Health Care for America Act of 2009 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Health Reform - Advocated to provide affordable health care coverage for all, protect and improve the Medicaid safety net, ensure hospital payment reductions coincide with coverage increases, preserve provider conscience protections & maintains current law on abortion, maintain consistency in requirements for charitable hospitals, and narrows the Medicare hospital readmissions policy & supports delivery system reforms to improve quality of care. S.AMDT.2991: Ammends H.R. 3590 Patient Protection and Affordable Care Act of 2009 - Provides states with the option to give legal immigrant families equitable access to health insurance. S. 1150 - Advance Care Planning & Compassionate Care Act of 2009 - A bill to improve end of life care S. 697 & H.R. 1721 - CLASS Act - Establised a national insurance program financed by voluntary payroll deductions to help individuals stay independent and remain in thier communities should the time come when they need assistance with activities of daily living.

Client expense: $280,000 · Firm income: Not reported

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

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. H.R.3590 The Patient Protection and Affordable Care Act. (House/Senate vehicle for health care reform legislation). .

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 795, the Elder Justice Act, to establish a multi-pronged, coordinated strategy to address elder abuse, neglect, and exploitation at the federal, state, and local levels and H.R. 448 and S. 1821, legislation to authorize the Department of Justice to provide grants to state and local law enforcement agencies, prosecutors and courts for improving the investigation and prosecution of elder abuse and to improve services to victims of such crimes. S. 1150, Advance Planning and Compassionate Care Act of 2009 - supporting components of legislation regarding advance planning and quality treatment of advanced chronic progressive conditions H.R. 1898, the Life Sustaining Treatment Preferences Act of 2009. H.R. 1255, legislation that would pertains to class actions and individuals who reside in intermediate care facilitiesinformation gathering only. General communications regarding issues related to adult guardianship data

Client expense: $290,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 610/ HR 1260 - Patient Reform Act of 2009 Long-Term Care S. 683/ H.R. 1670 - The Community Choice Act of 2009 H.R. 2516 - Medical Rights Act H.R. 2520 - Patients' Choice Act H.R. 463/ S. 21 - Prevention First Act of 2009 S.1150 - Advance Planning and Compassionate Care Act of 2009 S. 8 - Returning Government to the American People Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

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

H.R. 2 - Children's Health Insurance Program Reauthorization Act; H.R. 2638 - Consolidated Security, Disaster Assistance, and Continuing Appropriations Act; H.R. 2642 - Supplemental Appropriations for FY 2008; H.R. 2945 - Medicare Advantage Truth in Advertising Act; H.R. 3172 - Senior Navigation and Planning Act; H.R. 4296 - Medicare Electronic Medication and Safety Protection Act; H.R. 5613 - Protecting the Medicaid Safety Net Act; H.R. 6331 - Medicare Improvements for Patients and Providers Act of 2008; H.R. 6365 - Medicare Special Needs Plans Extension and Amendments Act of 2008; S. 1150 - Advance Planning and Compassionate Care Act of 2009; S. 1263 - Senior Navigation and Planning Act; S. 1507 - Access to Medicare Data Act; S. 1544 - Medicare Quality Enhancement Act; S. 1954 - Pharmacy Access Improvement Act; S. 2408 - Medicare Electronic Medication and Safety Protection Act; S. 3101 - Medicare Improvements for Patients and Providers Act of 2008; S. 3236 - The Medicare and Medicaid Extensions Act of 2008; S. 3560 - QI Program Supplemental Funding Act of 2008; H.R. 2758 - Special Needs Plans Reauthorization; S. 1307 - Special Needs Plans Reauthorization

Client expense: $1,080,000 · Firm income: Not reported

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

H.R. 3962: Affordable Health Care for America 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.3590: An act entitled The Patient Protection and Affordable Care Act - advocated for maintaining current law on abortion and preserving provider conscience protections, increase premium subsidies for low-income individuals and families, and reduce Medicare and Medicaid disproportional share hospital funding reductions. Health Reform - Advocated to provide affordable health care coverage for all, protect and improve the Medicaid safety net, ensure hospital payment reductions coincide with coverage increases, preserve provider conscience protections & maintains current law on abortion, maintain consistency in requirements for charitable hospitals, and narrows the Medicare hospital readmissions policy & supports delivery system reforms to improve quality of care. S.AMDT.2991: Ammends H.R. 3590 Patient Protection and Affordable Care Act of 2009 - Provides states with the option to give legal immigrant families equitable access to health insurance. S. 1150 - Advance Care Planning & Compassionate Care Act of 2009 - A bill to improve end of life care S. 697 & H.R. 1721 - CLASS Act - Establised a national insurance program financed by voluntary payroll deductions to help individuals stay independent and remain in thier communities should the time come when they need assistance with activities of daily living.

Client expense: $250,000 · Firm income: Not reported

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

Access to health care proposals--including access issues, privacy issues and legal remedies for those injured by malpractice. S. 1150, the Advance Planning and Compassionate Care Act - regarding advance planning and quality treatment of advanced chronic progressive conditions. Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008- comments related to equal access for mental health and addiction treatment. H.R. 3962, Affordable Health Care for America Act - Section 2537, Medical-Legal Partnerships H.R. 3590, Affordable Health Care for America Act, and H.R 3962, Patient Protection and Affordable Care Act, ABA generally supports access to quality heath care for all Americans and supports a number of provisions contained in H.R. 3590 and H.R 3962 including, provisions of S. 795 the Elder Justice Act (H.R. 3590), provisions on advance planning consultations (H.R. 3962), provisions to provide for parity in benefits for substance abuse disorders (both bills), provisions that would prohibit denying insurance benefits solely on the basis of the applicant's status as a victim of domestic violence (both bills), provisions to repeal the exemption from the federal antitrust laws for medical and health insurers (H.R. 3962); provisions to award grants to medical-legal partnerships to integrate lawyers in a healthcare setting to help patients navigate the complex legal system (H.R. 3962). ABA has principles related to the implementation of interstate health insurance compacts provisions in the legislation (both bills). ABA has policy related to provisions on legal remedies for those injured by malpractice (both bills) in support of voluntary dispute resolution after the dispute has arisen, apology legislation at the state level and pilot programs to collect information on near misses medical errors.

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

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

H.R. 1898, S. 1150, the Life Sustaining Treatment Preferences Act of 2009 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. S. 795, the Elder Justice Act, to establish a multi-pronged, coordinated strategy to address elder abuse, neglect, and exploitation at the federal, state, and local levels and H.R. 448 and S. 1821, legislation to authorize the Department of Justice to provide grants to state and local law enforcement agencies, prosecutors and courts for improving the investigation and prosecution of elder abuse and to improve services to victims of such crimes---ABA supports S. 1150, Advance Planning and Compassionate Care Act of 2009- supporting components legislation regarding advance planning and quality treatment of advanced chronic progressive conditions,

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

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. H.R.3590 The Patient Protection and Affordable Care Act. (House/Senate vehicle for health care reform legislation). .

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

Government targets: HOUSE OF REPRESENTATIVES, 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

S. 610/ HR 1260 - Patient Reform Act of 2009 S. 515 - The Patient Reform Act of 2009 Long-Term Care S. 683/ H.R. 1670 - The Community Choice Act of 2009 S. 4- Comprehensive Health Reform Act of 2009 H.R. 1296- Access For All America Act S. 697/ H.R. 1721 - The CLASS Act of 2009 H.R. 2516 - Medical Rights Act H.R. 1740/ S.994 - The EARLY Act H.R. 2520 - Patients' Choice Act H.R. 463/ S. 21 - Prevention First Act of 2009 S 1679 - Affordable Health Choices Act HR 3200 America's Affordable Health Choices Act of 2009 S 1150 - Advance Planning and Compassionate Care Act of 2009 S 1679 - Affordable Health Choices Act HR 3590 - The Patient Protection and Affordable Care Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

HR3200: 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. Senate Health Care Reform Legislation - advocated for affordable health coverage for all, improvements in the health care delivery system, adequate provider reimbursement, options to finance reform, conscience protections, and no federal funding for abortion. S. 1150 - Advance Care Planning & Compassionate Care Act of 2009 - A bill to improve end-of-life care. S.697 & H.R.1721 - CLASS Act - establishes a national insurance program financed by voluntary payroll deductions to help individuals stay independent and remain in their communities should the time come when they need assistance with activities of daily living. Immigration issues - advocating for the inclusion of legal immigrants in healthcare reform legislation.

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

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

Access to health care proposals--including access issues, privacy issues and legal remedies for those injured by malpractice. S. 1150, the Advance Planning and Compassionate Care Act - regarding advance planning and quality treatment of advanced chronic progressive conditions. Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008- comments related to equal access for mental health and addiction treatment.

Client expense: $290,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

HR 2758 - Special Needs Plans Reauthorization; HR 2945 - Medicare Advantage Truth in Advertising Act; HR 3172 - Senior Navigation and Planning Act; HR 6365 - Medicare Special Needs Plans Extension and Amendments Act of 2008; S 1150 - Advance Planning and Compassionate Care Act of 2009; S 1263 - Senior Navigation and Planning Act; S 1307 - Special Needs Plan Reauthorization; S 1544 - Medicare Quality Enhancement Act

Client expense: $1,010,000 · Firm income: Not reported

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

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL)), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R.1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. House Tri-Committee health care reform legislation.

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

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 - Engaged in discussions about the bill, possible changes to advance bill in health reform and it's provisions to balance Medicaid. Discussed chronic care issues and caregiver assessment in Medicaid. Discussed ways to provide better care coordination to dual eligibles and possible legislation (no bill). S.245/H.R. 468/S.434/H.R.468 Retooling the Health Care Workforce for an Aging America Act and possible amendment, the Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and shared endorsement letters. Discussed co-sponsors of Medicaid HCBS 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 this bill and versions marked up in committee. Endorsed provisions in HELP and E&C Committee healthcare reform bills. S.1131/H.R.2560 Independence at Home Act - Endorsed and discussed AARP's support for this Medicare care coordination bill; and House Committee amendment and urged co-sponsorship. 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 - To 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 - To reduce unnecessary hospital readmissions, improving quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; endorsed committee amendment; 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 - To 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 - To 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 - To 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), among other items (no bill numbers). S.750 Caring for an Aging america Act - Lobbied in support of legislation and discussed possible floor amendment.. 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. Responded to staff inquiry about AARP position on Medicare fraud bill; referred staff to appropriate AARP staff. 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 care coordination for dual eligibles and policy ideas to address this (no bill). Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1150 Advance Planning and Compassionate Care Act - Endorsed advance care planning legislation. S.1263 Senior Navigation and Planning Act legislation - discussed legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and urged cosponsors, advocated for amendment in committee. 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, 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.

Client expense: $5,680,000 · 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 - Engaged in discussions about the bill, possible changes to advance bill in health reform and it's provisions to balance Medicaid. Discussed chronic care issues and caregiver assessment in Medicaid. Discussed ways to provide better care coordination to dual eligibles and possible legislation (no bill). S.245/H.R. 468/S.434/H.R.468 Retooling the Health Care Workforce for an Aging America Act and possible amendment, the Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and shared endorsement letters. Discussed co-sponsors of Medicaid HCBS 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 this bill and versions marked up in committee. Endorsed provisions in HELP and E&C Committee healthcare reform bills. S.1131/H.R.2560 Independence at Home Act - Endorsed and discussed AARP's support for this Medicare care coordination bill; and House Committee amendment and urged co-sponsorship. 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 - To 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 - To reduce unnecessary hospital readmissions, improving quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; endorsed committee amendment; 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 - To 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 - To 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 - To 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), among other items (no bill numbers). S.750 Caring for an Aging america Act - Lobbied in support of legislation and discussed possible floor amendment.. 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. Responded to staff inquiry about AARP position on Medicare fraud bill; referred staff to appropriate AARP staff. 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 care coordination for dual eligibles and policy ideas to address this (no bill). Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1150 Advance Planning and Compassionate Care Act - Endorsed advance care planning legislation. S.1263 Senior Navigation and Planning Act legislation - discussed legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and urged cosponsors, advocated for amendment in committee. 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, 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.

Client expense: $5,680,000 · 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. 610/ HR 1260 - Patient Reform Act of 2009 S. 515 - The Patient Reform Act of 2009 Long-Term Care S. 683/ H.R. 1670 - The Community Choice Act of 2009 S. 4- Comprehensive Health Reform Act of 2009 H.R. 1296- Access For All America Act S. 697/ H.R. 1721 - The CLASS Act of 2009 H.R. 2516 - Medical Rights Act H.R. 1740/ S.994 - The EARLY Act H.R. 2520 - Patients' Choice Act H. Res. 437 - Mental Health Month H.R. 463/ S. 21 - Prevention First Act of 2009 S. 8 - Returning Government to the American People Act S 1679 - Affordable Health Choices Act HR 3200 America's Affordable Health Choices Act of 2009 HR 2516 - Medical Rights Act America's Health Future Act S 1150 - Advance Planning and Compassionate Care Act of 2009 HR 519 - Elder Caregiver Support and Information Enhancement Act of 2009

Client expense: $54,800 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

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. 3200, S. 1679, Senate Finance Committee Mark of Americas Healthy Futures Act: 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 Part D, reducing the Part A deductible, establishing an out-of-pocket maximum under Medicare, establishing a voluntary comprehensive benefit option under Medicare, authorizing a Medicare-operated Part D drug plan, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Parts D and 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, integrating mental health services in primary care and community settings, eliminating the 45 percent funding trigger provision, establishing a Medicare Commission, providing Medicaid coverage for home and community-based services, 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 and clarifying the Medicare Secondary Payer statute. 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. Medicaid/Home and Community-based Long Term Care. 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. 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.

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

Cancer research and treatment programs; Cancer research equipment; and comprehensive cancer related issues; and End of Life Care issues. S.1150, Advance Planning and Compassionate Care Act of 2009, End of Life Care issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2 - Children's Health Insurance Program Reauthorization Act; H.R. 2638 - Consolidated Security, Disaster Assistance, and Continuing Appropriations Act; H.R. 2642 - Supplemental Appropriations for FY 2008; H.R. 2945 - Medicare Advantage Truth in Advertising Act; H.R. 3172 - Senior Navigation and Planning Act; H.R. 4296 - Medicare Electronic Medication and Safety Protection Act; H.R. 5613 - Protecting the Medicaid Safety Net Act; H.R. 6331 - Medicare Improvements for Patients and Providers Act of 2008; H.R. 6365 - Medicare Special Needs Plans Extension and Amendments Act of 2008; S. 1150 - Advance Planning and Compassionate Care Act of 2009; S. 1263 - Senior Navigation and Planning Act; S. 1507 - Access to Medicare Data Act; S. 1544 - Medicare Quality Enhancement Act; S. 1954 - Pharmacy Access Improvement Act; S. 2408 - Medicare Electronic Medication and Safety Protection Act; S. 3101 - Medicare Improvements for Patients and Providers Act of 2008; S. 3236 - The Medicare and Medicaid Extensions Act of 2008; S. 3560 - QI Program Supplemental Funding Act of 2008; H.R. 2758 - Special Needs Plans Reauthorization; S. 1307 - Special Needs Plans Reauthorization

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

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

Access to health care proposals--including access issues, privacy issues and legal remedies for those injured by malpractice. Regulations to implement H.R. 2 (P.L. 111-3), Children's Health Insurance Program Reauthorization Act of 2009 S. 1150, the Advance Planning and Compassionate Care Act Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008- comments related to equal access for mental health and addiction treatment.

Client expense: $330,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), White House Office

S.1004/H.R. 2307 Reaching Elders with Assessment and Chronic Care Coordination Act. All provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaries with multiple chronic illnesses, including dementia. S697/HR1721, The Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S750, Caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S245/HR468 - Retooling for an Aging America, Building the Heatlhcare workforce. All provisions relating to expanding education and training opportunities in geriatric and long-term care for licensed health professionls, direct care workers, and family caregivers. HR1 - Healthcare provisions in the American Recovery and Reinvestment Act No bill number - health care reform legislation S.1150/HR 2911 - Advance Planning and Compassionate Act of 2009 - Establishes and operates directly or by grant, contract or interagency agreement, a 24-hour toll free telephone hotline to provide consumer information regarding advance planning.

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

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

Health Care Reform--advocated for affordable health coverage for all, improvements in the health care delivery system, adequate provider reimbursement, and options to finance reform. Labor/HHS/Appropriation bills--advocated for funding for children's health study, children's programs, aging programs, and provider support programs. H.R. 2496--CHIP Accessibility Act--To amend title XXI of the Social Security Act to improve access to the children's health insurance program (CHIP) by providing exemptions to CHIP eligibility waiting period requirements. Health Disparities and Language Access--advocated for legislation to improve health disparities and language access in health care programs. S. 697 & H.R. 1721--CLASS Act--A bill to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes. S. 1150--Advance Care Planning & Compassionate Care Act of 2009--A bill to improve end-of-life care. S. 1251& S. 1263--Senior Navigation and Planning Act of 2009--A bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes. S. 245& H.R. 468--Retooling the Health Care Workforce for an Aging America Act--A bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States.

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

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

H.R. 2 - Children's Health Insurance Program Reauthorization Act; H.R. 2638 - Consolidated Security, Disaster Assistance, and Continuing Appropriations Act; H.R. 2642 - Supplemental Appropriations for FY 2008; H.R. 2945 - Medicare Advantage Truth in Advertising Act; H.R. 3172 - Senior Navigation and Planning Act; H.R. 4296 - Medicare Electronic Medication and Safety Protection Act; H.R. 5613 - Protecting the Medicaid Safety Net Act; H.R. 6331 - Medicare Improvements for Patients and Providers Act of 2008; H.R. 6365 - Medicare Special Needs Plans Extension and Amendments Act of 2008; S. 1150 - Advance Planning and Compassionate Care Act of 2009; S. 1263 - Senior Navigation and Planning Act; S. 1507 - Access to Medicare Data Act; S. 1544 - Medicare Quality Enhancement Act; S. 1954 - Pharmacy Access Improvement Act; S. 2408 - Medicare Electronic Medication and Safety Protection Act; S. 3101 - Medicare Improvements for Patients and Providers Act of 2008; S. 3236 - The Medicare and Medicaid Extensions Act of 2008; S. 3560 - QI Program Supplemental Funding Act of 2008; H.R. 2758 - Special Needs Plans Reauthorization; S. 1307 - Special Needs Plans Reauthorization

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

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

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL)), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R.1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care.

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

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 - Engaged in discussions about the bill and it's provisions to balance Medicaid. Discussed ideas to balance state long-term care systems including enhanced FMAP provisions for Medicaid (no bill). Discussed chronic care issues and caregiver assessment in Medicaid. Provided feedback on Medicare Realigning CARE Act (?) chronic care coordinating HCBS and provided feedback on draft proposals (no bill). Discussed challenges to replication of the PACE program. Discussed lessons learned from PACE that could be applicable to dual eligible SNPs (no bill). Discussed ways to provide better care coordination to dual eligibles and possible legislation. S.647/H.R.7128, Nursing Home Transparency and Quality of Care Improvement Act - Discussed reintroduction of the Nursing Home Transparency and Improvement Act in the House and discussed feedback on the bill's provisions. Also discussed provisions of S.647 Nursing Home Quality of Care and Transparency and Improvement Act (S.647). S.245/H.R. 468/S.434/H.R.468 Retooling the Health Care Workforce for an Aging America Act, the Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and shared endorsement letters. Discussed co-sponsors of Medicaid HCBS legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Endorsed legislation on criminal background checks for employees of long-term care providers and specific bill provisions. Discussed system delivery reform in health care reform and logistics for testimony. Submitted delivery system reform testimony and comments to Finance Committee. Discussed health care reform substance and process in Finance and HELP Committees (no bill). Discussed Budget Committee letter on health care reform, shared AARP's position on the budget and health care reform. (no bill) S. 697/H.R.1721, Class Act - Discussed this bill, (next steps, scoring, actual analysis, testimony, markup and AARP position, S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for Medicare care coordination bill; a Hill briefing, bill reintroduction, and urged co-sponsorship. Discussed healthcare coverage for the 50-64 year old population and scheduled meetings for volunteers to share their coverage stories (no bill). S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - To 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 - To reduce unnecessary hospital readmissions, improving quality for Medicare beneficiaries, and reducing wasteful spending in Medicare. 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 - To 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 - To 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 - To 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. 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), among other items (no bill numbers). S.1004 Re-Aligning CARE Act - Discussed feedback on draft Re-aligning CARE Act and urged Sen. Lincoln to sponsor a bill to establish a transitional care benefit in Medicare. Discussed AARP proposal for a Medicare transitional care benefit (no bill number). Set up meeting with MedPAC staff to discuss Medicare transitional care benefit; meeting subsequently held. S.750 Caring for an Aging america Act - Lobbied in support of legislation. Discussed concerns over HHA regulation which would make it more difficult for state surveyors to share information about their surveys of nursing homes. (no 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) S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Inquired regarding use of Medicaid stimulus funds for an enhanced match in the Money Follows the Person Demonstration Program. Set up meetings to discuss AARP Health Care Reform priorities. Discussed Medicare physician payment issues and SGR. Inquired about information regarding a Medicare waiver and five New England states. Responded to staff inquiry about AARP position on Medicare fraud bill; referred staff to appropriate AARP staff. Discussed idea of an annual physical for Medicare beneficiaries. S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. Discussed care coordination for dual eligibles and policy ideas to address this. Provided information to help educate family caregivers about benefits under Medicare and Medicaid. (no bill) Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1150 Advance Planning and Compassionate Care Act - Discussed concerns on draft advance care planning legislation. S.1263 Senior Navigation and Planning Act - Discussed legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation.

Client expense: $5,300,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), 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

Senate Finance Committee Draft Policy Options (Baucus) - transitional care activities, accountable care organizations, Medicare Advantage funding, special needs plans, Medicare FFS payment reform, Medicaid eligibility expansion HR 3200 America's Affordable Health Choices Act (Waxman, Rangel, Miller)- accountable care organizations (Division B, Title III, Sec. 1301), medical homes (Division B, Title III, Section 1302), Medicare Advantage (Division B, Title I, Subtitle D), Special needs plans (Division B, Title I, Subtitle D, Sec. 1176 & 1177) S. 1133 (Wyden) Empowering Medicare Patient Choices Act (entire bill) HR 2580 (Blumenauer) Empowering Medicare Patient Choices Act (entire bill) S 1004 (Lincoln) RE-Aligning Care Act (entire bill) HR 2307 (Green) RE-Aligning Care Act (entire bill) S 1131 (Wyden) Independence at Home Act of 2009 (entire bill) HR 2560 (Markey) Independence at Home Act of 2009 (entire bill) S 1150 (Rockefeller) Advance Planning and Compassionate Care Act of 2009 (entire bill) HR 2911 (Blumenauer) Advance Planning and Compassionate Care Act of 2009 (entire bill) S 1009 (Bennet) Medicare Care Transitions Program Act of 2009 (entire bill)

Client expense: $95,800 · Firm income: Not reported

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

Comprehensive Health Care Reform. House Tri-Committee Discussion Draft, Senate Health, Education, Labor and Pensions Committee draft bill, Senate Finance Committee Description of Policy Options (No bill numbers as of this date): provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, reducing the Part A deductible, establishing an out-of-pocket maximum under Medicare, establishing a voluntary comprehensive benefit option under Medicare, authorizing a Medicare-operated Part D drug plan, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improvement of the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services, elimination of the 45 percent funding trigger provision, providing Medicaid coverage for home and community-based services, 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 and clarifying the Medicare Secondary Payer statute. 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 Means Testing. S. Amdt. 805 (to S. Con. Res. 13), S. 677: requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Part D. 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/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/Comparative Effectiveness. S. Amdt. 793 (to S. Con. Res. 13): prohibiting research information comparing the effectiveness of different treatments to deny coverage of products or services under federal health care programs including Medicare. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program. Medicare/Medicaid Reimbursement. S. Amdt. 799 (to S. Con. Res. 13): addressing the systemic inequities of Medicare and Medicaid reimbursement in rural areas. Medicaid/Home and Community-based Long Term Care. 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. 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.

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

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

Cancer research and treatment programs; Cancer research equipment; and comprehensive cancer related issues; and End of Life Care issues. S.1150, Advance Planning and Compassionate Care Act of 2009, End of Life Care issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2911, the Advance Planning and Compassionate Care Act of 2009 S. 1150, the Advance Planning and Compassionate Care Act of 2009 producitivty adjustment within health reform Hospice BNAF

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

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

HR 2911, Advance Planning and Compassionate Care Act of 2009 S 1150, Advance Planning and Compassionate Care Act of 2009 Congressional health reform - wage index productivity adjustment

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE