PATIENTS Act of 2009

Omnibus health Care Reform legislation to be introduced. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. H.R. 2520 - To provide comprehensive solutions for the health care system of the United States, and for other purposes. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679 - An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 3962 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 3590 - An act entitled The Patient Protection and Affordable Care Act. H.R. 4872 - Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

EPA memorandum of Understanding (MOU): MOU with EPA to help reduce amalgam in the environment; H.R. 2400, Strategies to Address Anti-microbial Resistance Act; STATE, Internation Agreement on Mercury Emissions; EPA - Proposed rule to protect waterways by reducing mercury from dental offices. S. 1259, Preserving Access to Targeted, Individualized, and Effective new Treatments and Service (PATIENTS) Act of 2009; H.R. 3856, Bone Health Promotion and Research Act of 2009; H.R. 4731, Lead in Dental Crowns issue; H.R. 2824, Doctor-Patient Relationship and Research Protection Act; S. 1213, Patient-Centered Outcomes Research Act of 2009; H.Res. 648, Expressing the need for enhanced public awareness of potential health effects posed by mercury; H.R. 4615, Consumers Have Options for Molar Protection Act of 2009; H.R. 4731, Medicaid Options for Dental Fillings Act of 2010. H.R. 5116/S. 3605, America COMPETES Reauthorization Act of 2010; Agency for Healthcare Research and Quality reauthorization; Agency for Healthcare Research and Quality , U.S. Preventative Services Taskforce; FDA Amalgam Classification; NIH, National Advisory on Dental & Craniofacial Research Council.

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

Government targets: Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, 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; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake; HR 4700 The Transparency in All Health Care Pricing Act of 2010, to provide for transparency in health care pricing; HR 4803 The Patients Right to Know Act, to ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information; HR 6072 and S 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010, to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 6376 to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services

Client expense: $4,270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

Omnibus health Care Reform legislation to be introduced. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. H.R. 2520 - To provide comprehensive solutions for the health care system of the United States, and for other purposes. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679 - An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 3962 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 3590 - An act entitled The Patient Protection and Affordable Care Act. H.R. 4872 - Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page three HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2400 Strategies to Address Antimicrobial Resistance Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page five HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2400 Strategies to Address Antimicrobial Resistance Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page three HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2400 Strategies to Address Antimicrobial Resistance Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page five HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2400 Strategies to Address Antimicrobial Resistance Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, 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; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake; HR 4700 The Transparency in All Health Care Pricing Act of 2010, to provide for transparency in health care pricing; HR 4803 The Patients Right to Know Act, to ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information.

Client expense: $4,230,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

EPA memorandum of Understanding (MOU): MOU with EPA to help reduce amalgam in the environment; H.R. 2400, Strategies to Address Anti-microbial Resistance Act; STATE, Internation Agreement on Mercury Emissions; S. 1259, Preserving Access to Targeted, Individualized, and Effective new Treatments and Service (PATIENTS) Act of 2009; H.R. 3856, Bone Health Promotion and Research Act of 2009; H.R. 4731, Lead in Dental Crowns issue; H.R. 2824, Doctor-Patient Relationship and Research Protection Act; S. 1213, Patient-Centered Outcomes Research Act of 2009; H.Res. 648, Expressing the need for enhanced public awareness of potential health effects posed by mercury; H.R. 4615, Consumers Have Options for Molar Protection Act of 2009; H.R. 4731, Medicaid Options for Dental Fillings Act of 2010. H.R. 5116, America COMPETES Reauthorization Act of 2010; AHRQ reauthorization; FDA Amalgam Classification;

Client expense: $690,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

Omnibus health Care Reform legislation to be introduced. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. H.R. 2520 - To provide comprehensive solutions for the health care system of the United States, and for other purposes. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679 - An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 3962 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 3590 - An act entitled The Patient Protection and Affordable Care Act. H.R. 4872 - Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 109, America's Affordable Health Care Act (Fortenberg) - essential benefits plan, high risk pools; H.R. 544, Flexible Health Savings Act (Royce) - FSA rollovers; H.R. 1086, Help Efficient, Accessible, Low-cost, Timely Healthcare Act (Gingrey) - medical liability reform; (cont.) HCR (Legislative) H.R. 1468, Medical Justice Act (Burgess) medical liability reform; H.R. 1493, Quality Health Care Coalition Act (Paul) antitrust exemption for physicians; H.R. 1658, Veterans Healthcare Commitment Act (Tiahrt) third party billing by VA for service-connected disabilities; H.R. 2221, Data Accountability and Trust Act (Rush) data security; H.R. 2249, Health Care Price Transparency Promotion Act (Burgess) price transparency; H.R. 2502, Comparative Effectiveness Research Act (Schrader) comparative effectiveness research; H.R. 2520, Patients Choice Act (Ryan) comprehensive health reform; H.R. 2607: Small Business Health Coverage (Johnson) association health plans; H.R. 2668, Choice in Health Options Insures Care for Everyone Act (Murphy) government run health plan; H.R. 2847, Jobs for Main Street Act (Mollohan) extension of COBRA subsidies for the unemployed; H.R. 3002, PATIENTS Act (Boehner) comparative effectiveness research; H.R. 3200, Americas Affordable Health Choices Act (Dingell) coverage expansions, quality improvements, delivery system reforms, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; H.R. 3400, Empowering Patients First Act (Price) premium subsidies, national marketplace, medical liability reforms, wellness, transparency, quality; H.R. 3468, Prevention and Wellness Programs (Castle) incentives for prevention and wellness; H.R. 3472, Premium Discounts for Healthy Behavior (Dahlkemper) premium discounts for healthy behavior; H.R. 3590, Patient Protection and Affordable Care Act (Reid) coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; H.R. 3962, Americas Affordable Health Choices Act (Dingell) coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; H.R. 4061, Cybersecurity Enhancement Act (Lipinski) privacy protections for health information technology; H.R. 4213, Tax Extenders Act (Rangel) COBRA assistance; H.R. 4691, Temporary Extension Act (Rangel) COBRA assistance; H.R. 4700, Transparency in All Health Care Pricing Act (Kagen) transparency in health care pricing; H.R. 4803, Patients' Right to Know Act (Barton) health benefits plan information, transparency in hospital price and quality information; H.R. 4851, Continuing Extension Act (Levin) COBRA assistance, electronic health records; S. 45, Medical Care Access Protection Act (Ensign) medical liability reform; S. 139, Data Breach Notification Act (Feinstein) data security; S. 179, Health Information Technology Act (Stabenow) health information technology; S. 458, False Claims Act Clarification Act (Grassley) fraud and abuse; S. 698, State-Based Health Care Reform Act (Feingold) pilot projects for state-based health reforms; S. 913, Workforce Health Improvement Program Act (Cornyn) wellness incentives; S. 988, SIMPLE Cafeteria Plan Act (Snowe) cafeteria plans, flexible spending arrangements; S. 1099, Patients Choice Act (Coburn) comprehensive health reform; S. 1213, Patient-Centered Outcomes Research Act (Baucus) comparative effectiveness research; S. 1259, PATIENTS Act (Kyl) comparative effectiveness research; S. 1278, Consumers Health Care Act (Rockefeller) government run health plan; S. 1490, Personal Data Privacy and Security Act (Leahy) privacy, identity theft; S. 1679, Affordable Health Choices Act (Harkin) coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; S. 1734, Medical Liability Reform (Kyl) medical liability reform; S. 1796, Americas Healthy Future Act (Baucus) coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; S. 2730, COBRA Subsidy Extension and Enhancement Act (Brown) COBRA subsidies for the unemployed; S. 3153, Continuing Extension Act (Grassley) COBRA assistance, electronic health records HCR (Regulatory Issues): HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets; HIPAA enforcement; FEHBP enrollment data clearinghouse initiative; issues relating to health insurance plan participation in FEHBP, including contract requirements related to interoperability of health information technology, community rating policies, and similarly sized subscriber group (SSSG) requirement; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to mental health parity; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; and issues relating to Form 5500 reporting requirements.

Client expense: $2,700,000 · Firm income: Not reported

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

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, 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; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake.

Client expense: $3,730,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

See page three HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page five HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page three HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page five HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

Drug safety and drug counterfeiting including H.R. 579, the Food and Drug Administration Globalization Act; Drug importation including S. 525/H.R. 1298, the Pharmaceutical Market Access and Drug Safety Act of 2009; S. 1232, Pharmaceutical Market Access and Drug Safety Act of 2009; H.R. 3590, Patient Protection and Affordable Care Act. Follow-on biologics including H.R. 1548, the Pathway to Biosimilars Act; S. 726/H.R. 1427, Promoting Innovation and Access to Life-Saving Medicines Act; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Physician payment disclosure including S. 301, Physician Payments Sunshine Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Comparative effectiveness including S. 1259, Preserving Access to Targeted, Individualized, and Effective New Treatments and Services Act of 2009; S. 1213, Patient-Centered Outcomes Research Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Authorized generics including H.R. 573; S. 501, Fair Prescription Drug Competition Act; Drug company settlements including S. 369, Preserve Access to Affordable Generics Act; H.R. 1706, Protecting Consumer Access to Generic Drugs Act; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Health care reform including H.R. 3200, America's Affordable Health Choices Act; S.___, Affordable Health Choices Act; and S.___, America's Healthy Future Act; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Prescription drug advertising; Federal preemption for prescription drugs; Legislation affecting telemedicine including H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Legislation concerning civil litigation including S. 357, Sunshine in Litigation Act of 2009.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Please see page three HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

Please see page five HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3590 Patient Protection and Affordable Care Act HR 3962 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

EPA Memorandum of Understanding (MOU): ADA agreement with EPA to help reduce amalgam in the environment; U.S. Preventative Services Task FOrce Nominations; National Institute of Dental and Craniofacial Research (NIDCR) Strategic Plan 2009-2013; H.R. 2400, Strategies to Address Antimicrobial Resistance Act; S. 1259, Preserving Access to Targeted, Individualized, and Effective new Treatments and Service (PATIENTS) Act of 2009; H.R. 3856, Bone Health Promotion and Research Act of 2009; H.R. 4731, Lead in Dental Crowns issue; H.R. 2824, Doctor-Patient Relationship and Research Protection Act; S. 1213, Patient-Centered Outcomes Research Act of 2009; H.Res. 648, Expressing the need for enhanced public awareness of potential health effects posed by mercury; H.R. 4615, Consumers Have Options for Molar Protection Act of 2009; H.R. 4731, Medicaid Options for Dental Fillings Act of 2010.

Client expense: $550,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

HR1 - American Recovery and Reinvestment Act S1213 - Patient Centered Outcomes Act of 2009; S1259 Patients Act of 2009; HR 1321 Healthy Americans Act; Expand CER, improve feedback to physicians, patient outcomes and protect innovation.

Client expense: $587,222 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of, White House Office

Coverage expansions, quality improvements, delivery system refors, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3962, To provide affordable, quality health care for all Americans and reduce the growth in healthcare spending, and for other purposes; HR 3590, Patient Protection and Affordable Care Act. Healthcare reform - HR 4872, Health Care and Education Reconciliation Act of 2010. *Coverage expansions, quality improvements, delivery system reforms, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3200, America's Affordable Health Choices Act. *Coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - S 1679, An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. *Essential benefits plan, high-risk pools - HR 109, To provide for the offering of Health Benefit Plans to individuals, to increase funding for State high risk health insurance pools, and to promote best practice protocols for State high risk pools. *FSA rollovers - HR 544, To amend the Internal Revenue Code of 1986 to allow amounts in a health flexible spending arrangement that are unused during a plan year to be carried over to subsequent plan years or deposited into certain health or retirement plans. *Data security - HR 2221, To protect consumers by requiring reasonable security policies and procedures to protect computerized data containing personal information, and to provide for nationwide notice in the event of a security breach; S 139, A bill to require Federal agencies, and persons engaged in interstate commerce, in possession of data containing sensitive personally identifiable information, to disclose any breach of such information. *Price transparency - HR 2249, To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. *Association health plans - HR 2607, To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. *Premium subsidies, national marketplace, medical liability reforms, wellness, transparency, quality - HR 3400, To provide for incentives to encourage health insurance coverage, and for other purposes. *Incentives for prevention and wellness - HR 3468, To amend the Internal Revenue Code of 1986, the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to promote the use of prevention and wellness programs. *Premium discounts for healthy behavior - HR 3472, To provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior. *Privacy, identity theft - S 1490, A bill to prevent and mitigate identity theft, to ensure privacy, to provide notice of security breaches, and to enhance criminal penalties, law enforcement assistance, and other protections against security breaches, fraudulent access, and misuse of personally identifiable information. *Medical liability reform - HR 1086, To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1468, To provide health care liability reform, and for other purposes; S 45, A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 1734, A bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform. *Antitrust exemption for physicians - HR 1493, To ensure and foster continued patient safety and quality of care by exempting health care professionals from the Federal antitrust laws in their negotiations with health plans and health insurance issuers. *Third-party billing by VA for service-connected disabilities - HR 1658, To amend title 38, United States Code, to prohibit the recovery by the United States of charges from a third party for hospital care or medical services furnished to a veteran for a service-connected disability. 8Health information technology - S 179, A bill to improve quality in health care by providing incentives for adoption of modern information technology. *uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system. *Comparative effectiveness research - HR 2502, To amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Comparative Effectiveness Research Trust Fund, and for other purposes; HR 3002, To protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1213, A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes; S 1259, A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. *Extension of COBRA subsidies for the unemployed - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes. *COBRA assistance - HR 4213, American Workers, State, and Business Relief Act of 2010 ; HR 4691, Temporary Extension Act of 2010 *COBRA assistance, electronic health records - HR 4851, Continuing Extension Act of 2010; S 3153, Continuing Extension Act of 2010. *Transparency in healthcare pricing - HR 4700, Transparency in All Health Care Pricing Act of 2010. *Health benefits plan information, transparency in hospital price and quality information - HR 4803, To ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information. *Privacy protections for health information technology - HR 4061, To advance cybersecurity research, development, and technical standards, and for other purposes. *Government-run health plan - HR 2668, To provide for the offering of an American Trust Health Plan to provide choice in health insurance options so as to ensure quality, affordable health coverage for all Americans; S 1278, A bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers. *Fraud and abuse - S 458, A bill to amend the False Claims Act. 8Wellness incentives - S 913, A bill to amend the Internal Revenue Code of 1986 to expand workplace health incentives by equalizing the tax consequences of employee athletic facility use. *Cafeteria plans, flexible spending arrangements - S 988, A bill to amend the Internal Revenue Code of 1986 to allow small businesses to set up simple cafeteria plans to provide nontaxable employee benefits to their employees, to make changes in the requirements for cafeteria plans, flexible spending accounts, and benefits provided under such plans or accounts, and for other purposes. *Comprehensive health reform - S 1099, A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes; HR 2520, To provide comprehensive solutions for the health care system of the United States, and for other purposes.

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

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

Omnibus health Care Reform legislation to be introduced. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. H. R. 2520 - To provide comprehensive solutions for the health care system of the United States, and for other purposes. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679 - An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 3962 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 4030 - To suspend temporarily the duty on Triethylenediamine. H.R. 3590 - An act entitled The Patient Protection and Affordable Care Act. H.R. 4872 - Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Coverage expansions, quality improvements, delivery system reforsm, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re these issue. Coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3962, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - S 1679, An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Single-payer health reform - HR 15, To provide a program of national health insurance, and for other purposes; HR 676, To provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 1200, To provide for health care for every American and to control the cost and enhance the quality of the health care system; S 703, A bill to provide for health care for every American and to control the cost and enhance the quality of the health care system. Essential benefits plan, high-risk pools - HR 109, To provide for the offering of Health Benefit Plans to individuals, to increase funding for State high risk health insurance pools, and to promote best practice protocols for State high risk pools. New government health program - HR 193, To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. FSA rollovers - HR 544, To amend the Internal Revenue Code of 1986 to allow amounts in a health flexible spending arrangement that are unused during a plan year to be carried over to subsequent plan years or deposited into certain health or retirement plans. Data security - HR 2221, To protect consumers by requiring reasonable security policies and procedures to protect computerized data containing personal information, and to provide for nationwide notice in the event of a security breach; S 139, A bill to require Federal agencies, and persons engaged in interstate commerce, in possession of data containing sensitive personally identifiable information, to disclose any breach of such information. Price transparency - HR 2249, To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. Association health plans - HR 2607, To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. High risk pool funding, comparative effectiveness research, HHS programs - HR 3292, To amend title 28, United States Code, to provide for a 6-month period for Federal judges to opt into the Judicial Survivors' Annuities System and begin contributing toward an annuity for their spouse and dependent children upon their death, and for other purposes; HR 3288, Making appropriations for the Departments of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2010, and for other purposes. Premium subsidies, national marketplace, medical liability reforms, wellness, transparency, quality - HR 3400, To provide for incentives to encourage health insurance coverage, and for other purposes. Incentives for prevention and wellness - HR 3468, To amend the Internal Revenue Code of 1986, the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to promote the use of prevention and wellness programs. Premium discounts for healthy behavior - HR 3472, To provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior. Privacy, identity theft - S 1490, A bill to prevent and mitigate identity theft, to ensure privacy, to provide notice of security breaches, and to enhance criminal penalties, law enforcement assistance, and other protections against security breaches, fraudulent access, and misuse of personally identifiable information. Medical liability reform - HR 1086, To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1468, To provide health care liability reform, and for other purposes; S 45, A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 1734, A bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform. Antitrust exemption for physicians - HR 1493, To ensure and foster continued patient safety and quality of care by exempting health care professionals from the Federal antitrust laws in their negotiations with health plans and health insurance issuers. Third-party billing by VA for service-connected disabilities - HR 1658, To amend title 38, United States Code, to prohibit the recovery by the United States of charges from a third party for hospital care or medical services furnished to a veteran for a service-connected disability. Health information technology - S 179, A bill to improve quality in health care by providing incentives for adoption of modern information technology. Pilot projects for State-based health reforms - S 698, A bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system. Comparative effectiveness research - HR 2502, To amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Comparative Effectiveness Research Trust Fund, and for other purposes; HR 3002, To protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1213, A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes; S 1259, A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. Coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3590, An act entitled The Patient Protection and Affordable Care Act. Extension of COBRA subsidies for the unemployed - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes; HR 3326, Making appropriations for the Department of Defense for the fiscal year ending September 30, 2010, and for other purposes. Privacy protections for health information technology - HR 4061, To advance cybersecurity research, development, and technical standards, and for other purposes. Government-run health plan - HR 2668, To provide for the offering of an American Trust Health Plan to provide choice in health insurance options so as to ensure quality, affordable health coverage for all Americans; S 1278, A bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers. Fraud and abuse - S 458, A bill to amend the False Claims Act. Wellness incentives - S 913, A bill to amend the Internal Revenue Code of 1986 to expand workplace health incentives by equalizing the tax consequences of employee athletic facility use. Cafeteria plans, flexible spending arrangements - S 988, A bill to amend the Internal Revenue Code of 1986 to allow small businesses to set up simple cafeteria plans to provide nontaxable employee benefits to their employees, to make changes in the requirements for cafeteria plans, flexible spending accounts, and benefits provided under such plans or accounts, and for other purposes. Comprehensive health reform - S 1099, A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes; HR 2520, To provide comprehensive solutions for the health care system of the United States, and for other purposes.

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

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

H.R. 15, National Health Insurance Act (Dingell) single-payer health reform; H.R. 109, America's Affordable Health Care Act (Fortenberg) essential benefits plan, high risk pools; H.R. 193, AmeriCare Health Care Act (Stark) new government health program; H.R. 544, Flexible Health Savings Act (Royce) FSA rollovers; H.R. 676, United States National Health Care Act (Conyers) single payer health reform; H.R. 1086, Help Efficient, Accessible, Low-cost, Timely Healthcare Act (Gingrey) medical liability reform; H.R. 1200, American Health Security Act (McDermott) single-payer health reform; H.R. 1468, Medical Justice Act (Burgess) medical liability reform; H.R. 1493, Quality Health Care Coalition Act (Paul) antitrust exemption for physicians; H.R. 1658, Veterans Healthcare Commitment Act (Tiahrt) third party billing by VA for service-connected disabilities; H.R. 2221, Data Accountability and Trust Act (Rush) data security; H.R. 2249, Health Care Price Transparency Promotion Act (Burgess) price transparency; H.R. 2502, Comparative Effectiveness Research Act (Schrader) comparative effectiveness research; H.R. 2520, Patients Choice Act (Ryan) comprehensive health reform; H.R. 2607: Small Business Health Coverage (Johnson) association health plans; H.R. 2668, Choice in Health Options Insures Care for Everyone Act (Murphy) government run health plan; H.R. 2847, Jobs for Main Street Act (Mollohan) extension of COBRA subsidies for the unemployed; H.R. 3002, PATIENTS Act (Boehner) comparative effectiveness research; H.R. 3200, Americas Affordable Health Choices Act (Dingell) coverage expansions, quality improvements, delivery system reforms, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; H.R. 3288, Consolidated Appropriations Act (Olver) high risk pool funding, comparative effectiveness research, HHS programs; H.R. 3293, Labor, HHS, Education Appropriations Act (Obey/Harkin) high risk pool funding, comparative effectiveness research, HHS programs; H.R. 3326, Defense Appropriations Act (Murtha) extension of COBRA subsidies for the unemployed; H.R. 3400, Empowering Patients First Act (Price) premium subsidies, national marketplace, medical liability reforms, wellness, transparency, quality; H.R. 3468, Prevention and Wellness Programs (Castle) incentives for prevention and wellness; H.R. 3472, Premium Discounts for Healthy Behavior (Dahlkemper) premium discounts for healthy behavior; H.R. 3590, Patient Protection and Affordable Care Act (Reid) coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; H.R. 3962, Americas Affordable Health Choices Act (Dingell) coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; H.R. 4061, Cybersecurity Enhancement Act (Lipinski) privacy protections for health information technology; S. 45, Medical Care Access Protection Act (Ensign) medical liability reform; S. 139, Data Breach Notification Act (Feinstein) data security; S. 179, Health Information Technology Act (Stabenow) health information technology; S. 458, False Claims Act Clarification Act (Grassley) fraud and abuse; S. 698, State-Based Health Care Reform Act (Feingold) pilot projects for state-based health reforms; S. 703, American Health Security Act (Sanders) single-payer health reform; S. 913, Workforce Health Improvement Program Act (Cornyn) wellness incentives; S. 988, SIMPLE Cafeteria Plan Act (Snowe) cafeteria plans, flexible spending arrangements; S. 1099, Patients Choice Act (Coburn) comprehensive health reform; S. 1213, Patient-Centered Outcomes Research Act (Baucus) comparative effectiveness research; S. 1259, PATIENTS Act (Kyl) comparative effectiveness research; S. 1278, Consumers Health Care Act (Rockefeller) government run health plan; S. 1490, Personal Data Privacy and Security Act (Leahy) privacy, identity theft; S. 1679, Affordable Health Choices Act (Harkin) coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; S. 1734, Medical Liability Reform (Kyl) medical liability reform; S. 1796, Americas Healthy Future Act (Baucus) coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; S. 2730, COBRA Subsidy Extension and Enhancement Act (Brown) COBRA subsidies for the unemployed HCR (Regulatory Issues): HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets; HIPAA enforcement; FEHBP enrollment data clearinghouse initiative; issues relating to health insurance plan participation in FEHBP, including contract requirements related to interoperability of health information technology, community rating policies, and similarly sized subscriber group (SSSG) requirement; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to mental health parity; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; and issues relating to Form 5500 reporting requirements.

Client expense: $2,540,000 · Firm income: Not reported

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

HR1 - American Recovery and Reinvestment Act: S1213 - Patient Centered Outcomes Act of 2009; S1259 Patients Act of 2009; HR 1321 - Healthy Americans Act; Expand CER, improve feedback to physicians, patient outcomes and protect innovation.

Client expense: $557,942 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of, White House Office

Brady/ Wilson Hospital Stimulus Letter to Obama Administration - Working with Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) urging their House colleagues to sign a letter asking the President to include relief for hospitals in the plan; HR 1 and S 1 American Recovery and Reinvestment Tax Act of 2009, HR 598 Assistance for Unemployed Workers and Struggling Families Act, HR 629 Health Information Technology for Economic and Clinical Health Act, S 350 Health Insurance Assistance for the Unemployed Act of 2009; HITECH Act Energy and Commerce Recovery and Reinvestment Act, all bills related to issues in the Economic Stimulus Bill pertaining to FMAP increase, DSH payments, moratoria through June 30 on Medicaid provider tax regs and hospital outpatient services, Medicare teaching hospitals IME, long-term care hospitals, health IT, tax exempt bonds, and provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health; HR 2 and S 275 Children's Health Insurance Program Reauthorization Act of 2009, provisions to secure health care coverage for more than 7 million low-income children currently covered by the State Childrens Health Insurance Program (SCHIP), to add coverage to nearly 4 million more, to improve coverage of dental and mental health benefits for children and to eliminate the five-year waiting period for coverage under SCHIP of legal immigrant children and pregnant women; S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, 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; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals.

Client expense: $5,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

Drug safety and drug counterfeiting including H.R. 579, the Food and Drug Administration Globalization Act; Drug importation including S. 525/H.R. 1298, the Pharmaceutical Market Access and Drug Safety Act of 2009; S. 1232, Pharmaceutical Market Access and Drug Safety Act of 2009; Follow-on biologics including H.R. 1548, the Pathway to Biosimilars Act; S. 726/H.R. 1427, Promoting Innovation and Access to Life-Saving Medicines Act; Physician payment disclosure including S. 301, Physician Payments Sunshine Act of 2009; Comparative effectiveness including H.R. 1, the American Recovery and Reinvestment Act; S. 1259, Preserving Access to Targeted, Individualized, and Effective New Treatments and Services Act of 2009; S. 1213, Patient-Centered Outcomes Research Act of 2009; Health information technology including H.R. 1, the American Recovery and Reinvestment Act; Authorized generics including H.R. 573; S. 501, Fair Prescription Drug Competition Act; Drug company settlements including S. 369, Preserve Access to Affordable Generics Act; H.R. 1706, Protecting Consumer Access to Generic Drugs Act; Health care reform including H.R. 3200, America's Affordable Health Choices Act; S.___, Affordable Health Choices Act; and S.___, America's Healthy Future Act; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; Prescription drug advertising; Federal preemption for prescription drugs; Legislation affecting telemedicine including H.R. 1, the American Recovery and Reinvestment Act; and Legislation concerning civil litigation including S. 357, Sunshine in Litigation Act of 2009.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Coverage expansions, quality improvements, delivery system reforsm, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re these issue. Coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3962, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - S 1679, An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Single-payer health reform - HR 15, To provide a program of national health insurance, and for other purposes; HR 676, To provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 1200, To provide for health care for every American and to control the cost and enhance the quality of the health care system; S 703, A bill to provide for health care for every American and to control the cost and enhance the quality of the health care system. Essential benefits plan, high-risk pools - HR 109, To provide for the offering of Health Benefit Plans to individuals, to increase funding for State high risk health insurance pools, and to promote best practice protocols for State high risk pools. New government health program - HR 193, To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. FSA rollovers - HR 544, To amend the Internal Revenue Code of 1986 to allow amounts in a health flexible spending arrangement that are unused during a plan year to be carried over to subsequent plan years or deposited into certain health or retirement plans. Data security - HR 2221, To protect consumers by requiring reasonable security policies and procedures to protect computerized data containing personal information, and to provide for nationwide notice in the event of a security breach; S 139, A bill to require Federal agencies, and persons engaged in interstate commerce, in possession of data containing sensitive personally identifiable information, to disclose any breach of such information. Price transparency - HR 2249, To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. Association health plans - HR 2607, To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. High risk pool funding, comparative effectiveness research, HHS programs - HR 3292, To amend title 28, United States Code, to provide for a 6-month period for Federal judges to opt into the Judicial Survivors' Annuities System and begin contributing toward an annuity for their spouse and dependent children upon their death, and for other purposes; HR 3288, Making appropriations for the Departments of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2010, and for other purposes. Premium subsidies, national marketplace, medical liability reforms, wellness, transparency, quality - HR 3400, To provide for incentives to encourage health insurance coverage, and for other purposes. Incentives for prevention and wellness - HR 3468, To amend the Internal Revenue Code of 1986, the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to promote the use of prevention and wellness programs. Premium discounts for healthy behavior - HR 3472, To provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior. Privacy, identity theft - S 1490, A bill to prevent and mitigate identity theft, to ensure privacy, to provide notice of security breaches, and to enhance criminal penalties, law enforcement assistance, and other protections against security breaches, fraudulent access, and misuse of personally identifiable information. Medical liability reform - HR 1086, To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1468, To provide health care liability reform, and for other purposes; S 45, A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 1734, A bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform. Antitrust exemption for physicians - HR 1493, To ensure and foster continued patient safety and quality of care by exempting health care professionals from the Federal antitrust laws in their negotiations with health plans and health insurance issuers. Third-party billing by VA for service-connected disabilities - HR 1658, To amend title 38, United States Code, to prohibit the recovery by the United States of charges from a third party for hospital care or medical services furnished to a veteran for a service-connected disability. Health information technology - S 179, A bill to improve quality in health care by providing incentives for adoption of modern information technology. Pilot projects for State-based health reforms - S 698, A bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system. Comparative effectiveness research - HR 2502, To amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Comparative Effectiveness Research Trust Fund, and for other purposes; HR 3002, To protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1213, A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes; S 1259, A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. Coverage expansions, quality improvements, delivery system reforms, cost containment, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - HR 3590, An act entitled The Patient Protection and Affordable Care Act. Extension of COBRA subsidies for the unemployed - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes; HR 3326, Making appropriations for the Department of Defense for the fiscal year ending September 30, 2010, and for other purposes. Privacy protections for health information technology - HR 4061, To advance cybersecurity research, development, and technical standards, and for other purposes. Government-run health plan - HR 2668, To provide for the offering of an American Trust Health Plan to provide choice in health insurance options so as to ensure quality, affordable health coverage for all Americans; S 1278, A bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers. Fraud and abuse - S 458, A bill to amend the False Claims Act. Wellness incentives - S 913, A bill to amend the Internal Revenue Code of 1986 to expand workplace health incentives by equalizing the tax consequences of employee athletic facility use. Cafeteria plans, flexible spending arrangements - S 988, A bill to amend the Internal Revenue Code of 1986 to allow small businesses to set up simple cafeteria plans to provide nontaxable employee benefits to their employees, to make changes in the requirements for cafeteria plans, flexible spending accounts, and benefits provided under such plans or accounts, and for other purposes. Comprehensive health reform - S 1099, A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes; HR 2520, To provide comprehensive solutions for the health care system of the United States, and for other purposes.

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

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

See page five HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3692 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009 HR 3590 Patient Protection and Affordable Care Act

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page three HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 HR 3692 Affordable Health Care for America Act S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009 HR 3590 Patient Protection and Affordable Care Act

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

EPA Memorandum of Understanding (MOU): MOU with EPA to help reduce amalgam in the environment. U.S. Preventive Services Task Force Nomination National Institute of Dental and Craniofacial Research (NIDCR) Strategic Plan 2009-2013 H.R. 2400 - Strategies to Address Antimicrobial Resistance Act H. Res. 648 'Expressing the need for enhanced public awareness of potential health effects posed by mercury. -- Submitted a letter to the FDA regarding the FDAs Final Rule for Dental Amalgam -- Prepared a Petition to the FDA for Classification of Tooth Whitening/Bleaching Products -- Attend meetings of the National Advisory Dental and Craniofacial Research Council H.R. 2824 Doctor-Patient Relationship and Research Protection Act S. 1213 Patient-Centered Outcomes Research Act of 2009 S. 1259 Preserving Access to Targeted, Individualized, and Effective New Treatments and Service (PATIENTS) Act of 2009 H.R. 3856 Bone Health Promotion and Research Act of 2009 White House Directive on Public Access to Publicly Funded Research AHRQ Reauthorization CDC NIOSH Strategic Plan FDA Final Rule for Dental Amalgam FDA Petition for Classification of Tooth Whitening/Bleaching Products FDA Dental Products Panel nomination(s)

Client expense: $550,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

H.R. 1427 - To amend the Public Health Service Act to provide for the licensing of biosimilar and biogeneric biological products, and for other purposes. S. 726 - A bill to amend the Public Health Service Act to provide for the licensing of biosimilar and biogeneric biological products, and for other purposes. H.R. 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. S. 1679 - An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 3962 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 3590 - An act entitled The Patient Protection and Affordable Care Act. S. 1796 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Omnibus health Care Reform legislation to be introduced. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. H. R. 2520 - To provide comprehensive solutions for the health care system of the United States, and for other purposes. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679 - An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 3962 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 4030 - To suspend temporarily the duty on Triethylenediamine. H.R. 3590 - An act entitled The Patient Protection and Affordable Care Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page five HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

Client expense: $125,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

See page three HR 1 American Recovery and Reinvestment Act of 2009 HR 805 / S 1028 Strengthening America's Public Health System Act H.R. 1105 FY 2009 Omnibus Appropriations Act HR 1321 Healthy Americans Act HR 1452 Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act of 2009 HR 1699 / S 1220 Patient Access to Critical Lab Tests Act HR 2502 Comparative Effectiveness Research Act of 2009 HR 2824 Doctor-Patient Relationship and Research Protection Act HR 2937/ S 1305 MRSA Infection Prevention and Patient Protection Act HR 3104 Healthy Hospitals Act of 2009 HR 3002 / S 1259 PATIENTS Act of 2009 HR 3200 America's Affordable Health Choices Act of 2009 S 1208 Strengthening America's Public Health System Act S 1213 Patient-Centered Outcomes Research Act of 2009 S 1220 Patient Access to Critical Lab Tests Act S 1299 Worker Infection Protection Act S. 1679 Affordable Health Choices Act S. 1796 America's Healthy Future Act of 2009

Client expense: $125,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

Brady/ Wilson Hospital Stimulus Letter to Obama Administration - Working with Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) urging their House colleagues to sign a letter asking the President to include relief for hospitals in the plan; HR 1 and S 1 American Recovery and Reinvestment Tax Act of 2009, HR 598 Assistance for Unemployed Workers and Struggling Families Act, HR 629 Health Information Technology for Economic and Clinical Health Act, S 350 Health Insurance Assistance for the Unemployed Act of 2009; HITECH Act Energy and Commerce Recovery and Reinvestment Act, all bills related to issues in the Economic Stimulus Bill pertaining to FMAP increase, DSH payments, moratoria through June 30 on Medicaid provider tax regs and hospital outpatient services, Medicare teaching hospitals IME, long-term care hospitals, health IT, tax exempt bonds, and provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health; HR 2 and S 275 Children's Health Insurance Program Reauthorization Act of 2009, provisions to secure health care coverage for more than 7 million low-income children currently covered by the State Childrens Health Insurance Program (SCHIP), to add coverage to nearly 4 million more, to improve coverage of dental and mental health benefits for children and to eliminate the five-year waiting period for coverage under SCHIP of legal immigrant children and pregnant women; S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, 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; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; Disclosure of Financial Relationships Report, argue for withdrawal of data collection form; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; S 1681Health Insurance Industry Antitrust Enforcement Act of 2009, a bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing.

Client expense: $3,830,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

Drug safety and drug counterfeiting including H.R. 579, the Food and Drug Administration Globalization Act; Drug importation including S. 525/H.R. 1298, the Pharmaceutical Market Access and Drug Safety Act of 2009; S. 1232, Pharmaceutical Market Access and Drug Safety Act of 2009; Follow-on biologics including H.R. 1548, the Pathway to Biosimilars Act; S. 726/H.R. 1427, Promoting Innovation and Access to Life-Saving Medicines Act; Physician payment disclosure including S. 301, Physician Payments Sunshine Act of 2009; Comparative effectiveness including H.R. 1, the American Recovery and Reinvestment Act; S. 1259, Preserving Access to Targeted, Individualized, and Effective New Treatments and Services Act of 2009; S. 1213, Patient-Centered Outcomes Research Act of 2009; Health information technology including H.R. 1, the American Recovery and Reinvestment Act; Authorized generics including H.R. 573; S. 501, Fair Prescription Drug Competition Act; Drug company settlements including S. 369, Preserve Access to Affordable Generics Act; H.R. 1706, Protecting Consumer Access to Generic Drugs Act; Health care reform including H.R. 3200, America's Affordable Health Choices Act; S.___, Affordable Health Choices Act; and S.___, America's Healthy Future Act; Prescription drug advertising; Federal preemption for prescription drugs; Legislation affecting telemedicine including H.R. 1, the American Recovery and Reinvestment Act; and Legislation concerning civil litigation including S. 357, Sunshine in Litigation Act of 2009.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3200, America's Affordable Health Choices Act of 2009, all provisions S. 1679, Affordable Health Choices Act, all provisions H.R. 3002, Preserving Access to Targeted, Individualized, and Effective New Treatments and Services (PATIENTS) Act of 2009, all provisions S. 1259, Preserving Access to Targeted, Individualized, and Effective New Treatments and Services (PATIENTS) Act of 2009, all provisions S. 334, Healthy Americans Act, all provisions H.R. 2520, Patients' Choice Act, all provisions S. 1099, Patients' Choice Act, all provisions America's Healthy Future Act of 2009, all provisions Medical Rights and Reform Act (Tuesday Group proposal), all provisions American Health Choices Act (Senate HELP bill), all provisions H.R. 1, American Recovery and Reinvestment Act of 2009, provisions on comparative effectiveness research H.R. 1859, Independent Drug Education and Outreach Act of 2009, all provisions S. 767, Independent Drug Education and Outreach Act of 2009, all provisions H.R. 1427, Promoting Innovation and Access to Life-Saving Medicine Act, all provisions S. 726, Promoting Innovation and Access to Life-Saving Medicine Act, all provisions H.R. 1548, Pathway for Biosimilars Act, all provisions S. 1142, Informed Health Care Decision Making Act, all provisions S. 1213, Patient-Centered Outcomes Research Act of 2009, all provisions H.R. 2824, Doctor-Patient Relationship and Research Protection Act, all provisions Health System Reform Health System Reform - Medicare Commission Health System Reform - Balance Billing/Private Contracting Health System Reform - Health Savings Accounts Physician-owned Hospitals Comparative Effectiveness Research (CER) Health Information Technology E-prescribing/controlled substances/DEA registration fees HIPAA Administrative Simplification/price transparency Quality improvement/PQRI Value Indexing/Quality FTC Red Flag Rules H1N1 public health emergency issues Patient access to physicians Coverage for the uninsured Patient Safety Non-therapeutic use of antibiotics in agriculture

Client expense: $3,950,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

All aspects of healthcare reform - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re these issues. Committee investigations into health insurance practices - Congressional inquiry. Single-payer health reform - HR 15, To provide a program of national health insurance, and for other purposes; HR 676, To provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 1200, To provide for health care for every American and to control the cost and enhance the quality of the health care system; S 703, A bill to provide for health care for every American and to control the cost and enhance the quality of the health care system. Essential benefits plan, high-risk pools - HR 109, To provide for the offering of Health Benefit Plans to individuals, to increase funding for State high risk health insurance pools, and to promote best practice protocols for State high risk pools. New government health program - HR 193, To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. FSA rollovers - HR 544, To amend the Internal Revenue Code of 1986 to allow amounts in a health flexible spending arrangement that are unused during a plan year to be carried over to subsequent plan years or deposited into certain health or retirement plans. Data security - HR 2221, To protect consumers by requiring reasonable security policies and procedures to protect computerized data containing personal information, and to provide for nationwide notice in the event of a security breach. Price transparency - HR 2249, To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. Association health plans - HR 2607, To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. High risk pool funding, comparative effectiveness research, HHS programs - HR 3292, To amend title 28, United States Code, to provide for a 6-month period for Federal judges to opt into the Judicial Survivors' Annuities System and begin contributing toward an annuity for their spouse and dependent children upon their death, and for other purposes. Premium subsidies, national marketplace, medical liability reforms, wellness, transparency, quality - HR 3400, To provide for incentives to encourage health insurance coverage, and for other purposes. Incentives for prevention and wellness - HR 3468, To amend the Internal Revenue Code of 1986, the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to promote the use of prevention and wellness programs. Premium discounts for healthy behavior - HR 3472, To provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior. Privacy, identity theft - S 1490, A bill to prevent and mitigate identity theft, to ensure privacy, to provide notice of security breaches, and to enhance criminal penalties, law enforcement assistance, and other protections against security breaches, fraudulent access, and misuse of personally identifiable information. Coverage expansions, quality improvements, delivery systems refors, health information technology, comparative effectiveness research, admin. simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse - S 1679, An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. Medical liability reform - HR 1086, To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1468, To provide health care liability reform, and for other purposes; S 45, A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 1734, A bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform. Antitrust exemption for physicians - HR 1493, To ensure and foster continued patient safety and quality of care by exempting health care professionals from the Federal antitrust laws in their negotiations with health plans and health insurance issuers. Third-party billing by VA for service-connected disabilities - HR 1658, To amend title 38, United States Code, to prohibit the recovery by the United States of charges from a third party for hospital care or medical services furnished to a veteran for a service-connected disability. Health information technology - S 179, A bill to improve quality in health care by providing incentives for adoption of modern information technology. Pilot projects for State-based health reforms - S 698, A bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system. Comparative effectiveness research - HR 2502, To amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Comparative Effectiveness Research Trust Fund, and for other purposes; HR 3002, To protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1213, A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes; S 1259, A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. Government-run health plan - HR 2668, To provide for the offering of an American Trust Health Plan to provide choice in health insurance options so as to ensure quality, affordable health coverage for all Americans; S 1278, A bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers. Fraud and abuse - S 458, A bill to amend the False Claims Act. Wellness incentives - S 913, A bill to amend the Internal Revenue Code of 1986 to expand workplace health incentives by equalizing the tax consequences of employee athletic facility use. Cafeteria plans, flexible spending arrangements - S 988, A bill to amend the Internal Revenue Code of 1986 to allow small businesses to set up simple cafeteria plans to provide nontaxable employee benefits to their employees, to make changes in the requirements for cafeteria plans, flexible spending accounts, and benefits provided under such plans or accounts, and for other purposes. Comprehensive health reform - S 1099, A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes; HR 2520, To provide comprehensive solutions for the health care system of the United States, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Americas Healthy Future Act (Baucus) coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse (cont.) HCR (cont.) H.R. 15, National Health Insurance Act (Dingell) single-payer health reform; H.R. 109, America's Affordable Health Care Act (Fortenberg) essential benefits plan, high risk pools; H.R. 193, AmeriCare Health Care Act (Stark) new government health program; H.R. 544, Flexible Health Savings Act (Royce) FSA rollovers; H.R. 676, United States National Health Care Act (Conyers) single payer health reform; H.R. 1086, Help Efficient, Accessible, Low-cost, Timely Healthcare Act (Gingrey) medical liability reform; H.R. 1200, American Health Security Act (McDermott) single-payer health reform; H.R. 1468, Medical Justice Act (Burgess) medical liability reform; H.R. 1493, Quality Health Care Coalition Act (Paul) antitrust exemption for physicians; H.R. 1658, Veterans Healthcare Commitment Act (Tiahrt) third party billing by VA for service-connected disabilities; H.R. 2221, Data Accountability and Trust Act (Rush) data security; H.R. 2249, Health Care Price Transparency Promotion Act (Burgess) price transparency; H.R. 2502, Comparative Effectiveness Research Act (Schrader) comparative effectiveness research; H.R. 2520, Patients Choice Act (Ryan) comprehensive health reform; H.R. 2607: Small Business Health Coverage (Johnson) association health plans; H.R. 2668, Choice in Health Options Insures Care for Everyone Act (Murphy) government run health plan; H.R. 3002, PATIENTS Act (Boehner) comparative effectiveness research; H.R. 3200, Americas Affordable Health Choices Act (Dingell) coverage expansions, quality improvements, delivery system reforms, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; H.R. 3293, Labor, HHS, Education Appropriations Act (Obey/Harkin) high risk pool funding, comparative effectiveness research, HHS programs; H.R. 3400, Empowering Patients First Act (Price) premium subsidies, national marketplace, medical liability reforms, wellness, transparency, quality; H.R. 3468, Prevention and Wellness Programs (Castle) incentives for prevention and wellness; H.R. 3472, Premium Discounts for Healthy Behavior (Dahlkemper) premium discounts for healthy behavior; S. 45, Medical Care Access Protection Act (Ensign) medical liability reform; S. 179, Health Information Technology Act (Stabenow) health information technology;S. 458, False Claims Act Clarification Act (Grassley) fraud and abuse; S. 698, State-Based Health Care Reform Act (Feingold) pilot projects for state-based health reforms; S. 703, American Health Security Act (Sanders) single-payer health reform; S. 913, Workforce Health Improvement Program Act (Cornyn) wellness incentives; S. 988, SIMPLE Cafeteria Plan Act (Snowe) cafeteria plans, flexible spending arrangements; S. 1099, Patients Choice Act (Coburn) comprehensive health reform; S. 1213, Patient-Centered Outcomes Research Act (Baucus) comparative effectiveness research; S. 1259, PATIENTS Act (Kyl) comparative effectiveness research; S. 1278, Consumers Health Care Act (Rockefeller) government run health plan; S. 1490, Personal Data Privacy and Security Act (Leahy) privacy, identity theft; S. 1679, Affordable Health Choices Act (Harkin) coverage expansions, quality improvements, delivery system reforms, health information technology, comparative effectiveness research, administrative simplification, health disparities, prevention and wellness, public health and workforce issues, fraud and abuse; S. 1734, Medical Liability Reform (Kyl) medical liability reform HCR (Regulatory Issues): HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets; FEHBP enrollment data clearinghouse initiative; issues relating to health insurance plan participation in FEHBP, including contract requirements related to interoperability of health information technology, community rating policies, and similarly sized subscriber group (SSSG) requirement; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to mental health parity; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; and issues relating to Form 5500 reporting requirements.

Client expense: $2,410,000 · Firm income: Not reported

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

H.R. 1427 - To amend the Public Health Service Act to provide for the licensing of biosimilar and biogeneric biological products, and for other purposes. S. 726 - A bill to amend the Public Health Service Act to provide for the licensing of biosimilar and biogeneric biological products, and for other purposes. H.R. 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. S. 1679 - An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Omnibus health Care Reform legislation to be introduced. S. 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes. S. 1259 - A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. H. R. 2520 - To provide comprehensive solutions for the health care system of the United States, and for other purposes. H.R. 3200 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1697 - A bill to require that household cleaning products and similar products bear labels that state completely and accurately all of the ingredients of such products, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Brady/ Wilson Hospital Stimulus Letter to Obama Administration - Working with Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) urging their House colleagues to sign a letter asking the President to include relief for hospitals in the plan; HR 1 and S 1 American Recovery and Reinvestment Tax Act of 2009, HR 598 Assistance for Unemployed Workers and Struggling Families Act, HR 629 Health Information Technology for Economic and Clinical Health Act, S 350 Health Insurance Assistance for the Unemployed Act of 2009; HITECH Act Energy and Commerce Recovery and Reinvestment Act, all bills related to issues in the Economic Stimulus Bill pertaining to FMAP increase, DSH payments, moratoria through June 30 on Medicaid provider tax regs and hospital outpatient services, Medicare teaching hospitals IME, long-term care hospitals, health IT, tax exempt bonds, and provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health; HR 2 and S 275 Children's Health Insurance Program Reauthorization Act of 2009, this bill will secure health care coverage for more than 7 million low-income children currently covered by the State Childrens Health Insurance Program (SCHIP) and add coverage to nearly 4 million more. It also contains provisions to improve coverage of dental and mental health benefits for children and to eliminate the five-year waiting period for coverage under SCHIP of legal immigrant children and pregnant women; S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, 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; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, would prohibit health insurers from denying coverage to people with pre-existing conditions, such as diabetes and heart disease; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176Nursing and Allied Health Education Preservation Act of 2009A bill to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957Public Health Emergency Response Act of 2009A bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2292 Healthy Kids for Healthy Futures Act of 2009A bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets, and for other purposes; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; Disclosure of Financial Relationships Report, argue for withdrawal of data collection form; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824Doctor-Patient Relationship and Research Protection ActTo enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections, such as MRSA; Hatch amendment # 21 requires the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; Health Reform Bill, pProvides access to quality affordable health care for all. The health reform package includes: ACCESS TO COVERAGE AND CHOICE, AFFORDABILITY, SHARED RESPONSIBILITY, CONTROLLING COSTS, PREVENTION AND WELLNESS, WORKFORCE INVESTMENTS; HR 2962 Integrity in Medicare Advanced Diagnostic Imaging Act of 2009, a bill to amend title XVIII of the Social Security Act to exclude certain advanced diagnostic imaging services from the in-office ancillary services exception to the prohibition on physician self-referral; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas.

Client expense: $3,490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office