Senior Navigation and Planning Act of 2009

HR 27 Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the SCHIP for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465 a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a CMS Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS); Working on legislation to amend the Medicare Recovery Audit Contractor Program; S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and(d) of section 114 of the Medicare, Medicaid, & SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letters and further discussions to CMS, Physician Supervision for Outpatient Service, resend policy changes requiring direct physician supervision for all PSO therapeutic Outpatient Service provided in and on hospital campus under Medicare, and withdraw change to minimize legal risk for years 2001-2009; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009, a bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals; HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262 Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the MedPAC on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 MedPAC Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the MedPAC, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; H.R. 3138 Physician Payments Sunshine Act of 2009, a bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP; HR 3141 Strengthening the Health Care Safety Net Act of 2009, a bill to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 3152 Helping Seniors Choose their Medicare Drug Plan Act, a bill to amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs; S. 1423 Medicaid Birth Center Reimbursement Act, a bill to amend title XIX of the Social Security Act to require coverage under the Medicaid Program for freestanding birth center services; S. 1427 Department of Veterans Affairs Hospital Quality Report Card Act of 2009, a bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Department of Veterans Affairs Medical Centers, and for other purposes; H.R. 3172 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; H.R. 3184 Medicare Independent Living Act of 2009, a bill to amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; H.R. 3256 Rural Community Hospital Demonstration Extension Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; H.R. 3356 Medicare Beneficiary Freedom to Choose Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits; H.R. 3361 Medicare Patient Safeguards Act of 2009, a bill to provide a process for public comment and Medicare Evidence Development & Coverage Advisory Committee review of certain Medicare national coverage determinations, and for other purposes; HR 3369 and S.1521 Improve Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to require provider payments under Medicare and Medicaid to be made through direct deposit or electronic funds transfer (EFT) at insured depository institutions; S.1522 Outpatient Mental Health Modernization Act of 2009, a bill to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program; H.R. 3374 Medicare and Medicaid Access Project through Information Technology (MAP IT) Act, a bill to provide for a demonstration project relating to the impact of health information technology on chronic disease management under the Medicare and Medicaid programs; H.R. 3422 Medicare Support for Rural Hospitals Act, a bill to amend title XVIII of the Social Security Act to make temporary improvements to the Medicare inpatient payment adjustment for low-volume hospitals; H.R. 3430 DSH Collaborative Care Network Pilot Program Act of 2009, a bill to establish a Medicare DSH pilot program under which participants shall establish collaborative care networks to reduce the use of emergency departments, inpatient and other expensive resources of hospitals and other providers and provide more comprehensive and coordinated care to low-income individuals, including those without health insurance coverage, and to establish a Collaborative Care Network Center; Neal Letter to Pelosi, Opposition to the Independent Medicare Advisory Council (IMAC) and MedPAC Reform Act (HR 2718, S1110, S 1380); HR 3556 NO TITLE, a bill to require the Secretary of Health and Human Services to establish a self-referral disclosure protocol under the Medicare Program to enable health care providers of services and suppliers to disclose violations of section 1877 of the Social Security Act; S 1669 Equal Access to Medicare Options Act of 2009, a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy; HR 3631 Medicare Premium Fairness Act, a bill to amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010; HR 3653 Medicare Card Security Act of 2009, a bill to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; HR 3663 NO TITLE, a bill to amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; HR 3665 Ryan White Grantee Medicaid Payment Equity Act of 2009, a bill to amend title XIX of the Social Security Act to provide for payment for Medicaid services furnished by Ryan White part C grantees under a cost-based prospective payment system; HR 3675 National Quality Cancer Care Demonstration Project Act of 2009, a bill to improve the quality and cost effectiveness of cancer care to Medicare beneficiaries by establishing a national demonstration project; 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; Meeting with CMS re implementation of new requirements for insurance providers to report payment responsibility for Medicare Secondary Payer program; HR 3693 Ensuring the Future Physician Workforce Act of 2009, a bill to amend title XVIII of the Social Security Act to modify Medicare physician reimbursement policies to ensure a future physician workforce; HR 3961, HR 4154, S 1600 and Reid amendment 3305 Medicare Physician Payment Reform Act of 2009 and Statutory Pay-As-You-Go Act of 2009, a bill to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians and to reinstitute and update the Pay-As-You-Go requirement of budget neutrality on new tax and mandatory spending legislation, enforced by the threat of annual, automatic sequestration; HR 4250 Medicaid DSH Integrity Act, a bill to direct the Secretary of Health and Human Services to revise regulations implementing the statutory reporting and auditing requirements for the Medicaid disproportionate share hospital ("DSH") payment program to be consistent with the scope of the statutory provisions and avoid substantive changes to preexisting DSH policy; S 1776 Medicare Physician Fairness Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes; discussion with the HHS Office of the National Coordinator for Health Information Technology of hospital concerns around development of requirements for meaningful use of Electronic Health Records (EHR) to qualify for Medicare and Medicaid incentive payments for EHR development; S 3000 a bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months; HR 4213 American Workers, State, and Business Relief Act of 2010 a bill that includes an extension of the Recovery Acts increased Federal match for state Medicaid programs. The passed bill extends the increased FMAP through June 30, 2011, which is estimated to provide states with an additional $25.5 billion in FMAP; Letter to Pelosi and Reid expressing opposition to establishment of an Independent Payment Advisory Board (IPAB); Medicaid FMAP ARRA Extension Letter to Senator Reid to include an extension of federal Medicaid assistance to states in legislative proposals to increase employment and rebuild the nations economy; Space, Burgess, Stearns and Engel House Health IT letter and Klobuchar and Hatch Senate Health IT letter to CMS urging a modification of CMS proposed definition of and requirements for hospitals to become qualified as meaningful users of certified electronic health record (EHR) technology; S 3028 Medicare Mental Health Inpatient Equity Act, to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare program; HR 4872 The Health Care and Education Affordability Reconciliation Act of 2010, to provide for reconciliation pursuant to section 202 of the concurrent resolution on the budget for fiscal year 2010; Meetings with CMS to urge a different interpretation of the Medicare conditions of participation interpretive guidelines, as currently interpreted guidelines would require accreditation of each hospital as a standalone entity and require them to each have a separate governing body, medical staff, etc. in order to be accredited by the joint commission; Crowley- Sessions Letter to CMS urging reevaluation of the IPPS regulation that would apply a 2.9 percent cut to hospital payments in FY 2011; Letter to CMS re development of the Self-referral disclosure protocol that is authorized by the PPACA; HR 5712 Veterans, Seniors, and Childrens Health Technical Corrections Act of 2010 to provide for certain clarifications and extensions under Medicare, Medicaid, and the Children's Health Insurance Program; HR 6005 Ensuring Equality for Early EHR Adoption Act of 2010, to amend titles XVIII and XIX of the Social Security Act to provide for the temporary treatment of certain electronic health records as certified EHR technology for purposes of health information technology payment incentives under the Medicare and Medicaid Programs. Sen. Stabenow and Sen. Murkoswki, Rep. Crowley and Rep. Sessions letter to CMS asking to reevaluate the proposed IPPS regulations that will hit hospital payments in FY 2011; Pomeroy, Moran letter to CMS, regarding concersn of the proposed Medicare OPPS regulation for FY 2011 does not show continued access to full range of outpatient therapeutic services for small, rural & CAH hospitals.

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

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H.R. 795 (Towns), S. 686 (Mikulski) Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act Issue: Health/Social Work Workforce - Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work. H. R. 4872 (Spratt) Health Care and Education Reconciliation Act of 2010 Support an Act to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010. The bill makes a number of health-related financing and revenue changes to the Patient Protection and Affordable Care Act enacted by H.R.3590 and modifies higher education assistance programs. H.R. 3962 (Dingell), H.R. 3590, (Rangel) Affordable Health Care for America Act Issues: Health System Reform - Support a bill to provide affordable, guaranteed health coverage that will make Americans healthier and can never be taken away. S. 711, H.R. 2058 Post Deployment Health Assessment Act of 2009. A bill to require mental health screenings for members of the Armed Forces who are deployed in connection with a contingency operation, and for other purposes. H.R. 840 Military Domestic Violence and Sexual Assault Response Act. To reduce sexual assault and domestic violence involving members of the Armed Forces and their family members and partners through enhanced programs of prevention and deterrence, enhanced programs of victims services, and strengthened provisions for prosecution of assailants, and for other purposes. H.R. 3200 Americas Affordable Health Choices Act. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 795 and S.686, Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act. Support establishing a Social Work Reinvestment Commission to address recruitment, retention, research, and reinvestment in the social work profession. S. 114, National Center for Social Work Research Act. Support establishing the National Center for Social Work Research as an agency of the National Institutes of Health (NIH) to conduct, support, and disseminate targeted research on social work methods and outcomes related to problems of significant social concern. S. 1403, Strengthen Social Work Training Act of 2009 Support ensuring 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. H.R. 1490, Teri Zenner Social Worker Safety Act Support establishing a grant program to assist in the provision of safety measures to protect social workers and other professionals who work with at-risk populations. H.R. 3590, Patient Protection and Affordable Care Act (PL 111-148) Support a bill to provide affordable, quality health care for all Americans. The bill is the Senate vehicle for health care reform legislation. The legislation passed and signed into law on March 23, 2010. The focus is the implementation the law. H.R.4872, Health Care & Education Reconciliation Act (PL 111-152) Support the reconciliation bill that makes several changes to the Patient Protection and Affordable Care Act and deal with student loan reform. The legislation passed and was signed into law on March 30, 2010. The focus is now on implementation of the law. S.1263/ H.R.3172, Senior Navigation and Planning Act of 2009 Support the effort to provide for advanced illness care management services for Medicare beneficiaries. H.R.4594/ S.2982, International Violence Against Women Act of 2010 Support efforts to combat international violence against women and girls. H.R. 4123/S. 2809, Alzheimer's Treatment and Caregiver Support Act Support legislation that would provide grants to public and non-profit organizations to improve treatment for individuals with Alzheimer's disease, and expand training and support services for caregivers. H.R. Res. 1342/ S. Res. 553, Senior's Bill of Rights Support resolution expressing the sense of the House of Representative and the Senate that Congress should unwaveringly uphold the dignity and independence of older Americans.

HR 27 Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the SCHIP for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465 a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a CMS Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS); Working on legislation to amend the Medicare Recovery Audit Contractor Program; S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and(d) of section 114 of the Medicare, Medicaid, & SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letters and further discussions to CMS, Physician Supervision for Outpatient Service, resend policy changes requiring direct physician supervision for all PSO therapeutic Outpatient Service provided in and on hospital campus under Medicare, and withdraw change to minimize legal risk for years 2001-2009; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009, a bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals; HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262 Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the MedPAC on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 MedPAC Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the MedPAC, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; H.R. 3138 Physician Payments Sunshine Act of 2009, a bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP; HR 3141 Strengthening the Health Care Safety Net Act of 2009, a bill to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 3152 Helping Seniors Choose their Medicare Drug Plan Act, a bill to amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs; S. 1423 Medicaid Birth Center Reimbursement Act, a bill to amend title XIX of the Social Security Act to require coverage under the Medicaid Program for freestanding birth center services; S. 1427 Department of Veterans Affairs Hospital Quality Report Card Act of 2009, a bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Department of Veterans Affairs Medical Centers, and for other purposes; H.R. 3172 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; H.R. 3184 Medicare Independent Living Act of 2009, a bill to amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; H.R. 3256 Rural Community Hospital Demonstration Extension Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; H.R. 3356 Medicare Beneficiary Freedom to Choose Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits; H.R. 3361 Medicare Patient Safeguards Act of 2009, a bill to provide a process for public comment and Medicare Evidence Development & Coverage Advisory Committee review of certain Medicare national coverage determinations, and for other purposes; HR 3369 and S.1521 Improve Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to require provider payments under Medicare and Medicaid to be made through direct deposit or electronic funds transfer (EFT) at insured depository institutions; S.1522 Outpatient Mental Health Modernization Act of 2009, a bill to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program; H.R. 3374 Medicare and Medicaid Access Project through Information Technology (MAP IT) Act, a bill to provide for a demonstration project relating to the impact of health information technology on chronic disease management under the Medicare and Medicaid programs; H.R. 3422 Medicare Support for Rural Hospitals Act, a bill to amend title XVIII of the Social Security Act to make temporary improvements to the Medicare inpatient payment adjustment for low-volume hospitals; H.R. 3430 DSH Collaborative Care Network Pilot Program Act of 2009, a bill to establish a Medicare DSH pilot program under which participants shall establish collaborative care networks to reduce the use of emergency departments, inpatient and other expensive resources of hospitals and other providers and provide more comprehensive and coordinated care to low-income individuals, including those without health insurance coverage, and to establish a Collaborative Care Network Center; Neal Letter to Pelosi, Opposition to the Independent Medicare Advisory Council (IMAC) and MedPAC Reform Act (HR 2718, S1110, S 1380); HR 3556 NO TITLE, a bill to require the Secretary of Health and Human Services to establish a self-referral disclosure protocol under the Medicare Program to enable health care providers of services and suppliers to disclose violations of section 1877 of the Social Security Act; S 1669 Equal Access to Medicare Options Act of 2009, a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy; HR 3631 Medicare Premium Fairness Act, a bill to amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010; HR 3653 Medicare Card Security Act of 2009, a bill to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; HR 3663 NO TITLE, a bill to amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; HR 3665 Ryan White Grantee Medicaid Payment Equity Act of 2009, a bill to amend title XIX of the Social Security Act to provide for payment for Medicaid services furnished by Ryan White part C grantees under a cost-based prospective payment system; HR 3675 National Quality Cancer Care Demonstration Project Act of 2009, a bill to improve the quality and cost effectiveness of cancer care to Medicare beneficiaries by establishing a national demonstration project; 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; Meeting with CMS re implementation of new requirements for insurance providers to report payment responsibility for Medicare Secondary Payer program; HR 3693 Ensuring the Future Physician Workforce Act of 2009, a bill to amend title XVIII of the Social Security Act to modify Medicare physician reimbursement policies to ensure a future physician workforce; HR 3961, HR 4154, S 1600 and Reid amendment 3305 Medicare Physician Payment Reform Act of 2009 and Statutory Pay-As-You-Go Act of 2009, a bill to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians and to reinstitute and update the Pay-As-You-Go requirement of budget neutrality on new tax and mandatory spending legislation, enforced by the threat of annual, automatic sequestration; HR 4250 Medicaid DSH Integrity Act, a bill to direct the Secretary of Health and Human Services to revise regulations implementing the statutory reporting and auditing requirements for the Medicaid disproportionate share hospital ("DSH") payment program to be consistent with the scope of the statutory provisions and avoid substantive changes to preexisting DSH policy; S 1776 Medicare Physician Fairness Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes; discussion with the HHS Office of the National Coordinator for Health Information Technology of hospital concerns around development of requirements for meaningful use of Electronic Health Records (EHR) to qualify for Medicare and Medicaid incentive payments for EHR development; S 3000 a bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months; HR 4213 American Workers, State, and Business Relief Act of 2010 a bill that includes an extension of the Recovery Acts increased Federal match for state Medicaid programs. The passed bill extends the increased FMAP through June 30, 2011, which is estimated to provide states with an additional $25.5 billion in FMAP; Letter to Pelosi and Reid expressing opposition to establishment of an Independent Payment Advisory Board (IPAB); Medicaid FMAP ARRA Extension Letter to Senator Reid to include an extension of federal Medicaid assistance to states in legislative proposals to increase employment and rebuild the nations economy; Space, Burgess, Stearns and Engel House Health IT letter and Klobuchar and Hatch Senate Health IT letter to CMS urging a modification of CMS proposed definition of and requirements for hospitals to become qualified as meaningful users of certified electronic health record (EHR) technology; S 3028 Medicare Mental Health Inpatient Equity Act, to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare program; HR 4872 The Health Care and Education Affordability Reconciliation Act of 2010, to provide for reconciliation pursuant to section 202 of the concurrent resolution on the budget for fiscal year 2010; Meetings with CMS to urge a different interpretation of the Medicare conditions of participation interpretive guidelines, as currently interpreted guidelines would require accreditation of each hospital as a standalone entity and require them to each have a separate governing body, medical staff, etc. in order to be accredited by the joint commission; Crowley- Sessions Letter to CMS urging reevaluation of the IPPS regulation that would apply a 2.9 percent cut to hospital payments in FY 2011.

HR 27 Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the SCHIP for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465 a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a CMS Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS); Working on legislation to amend the Medicare Recovery Audit Contractor Program; S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and(d) of section 114 of the Medicare, Medicaid, & SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letters and further discussions to CMS, Physician Supervision for Outpatient Service, resend policy changes requiring direct physician supervision for all PSO therapeutic Outpatient Service provided in and on hospital campus under Medicare, and withdraw change to minimize legal risk for years 2001-2009; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009, a bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals; HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262 Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the MedPAC on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 MedPAC Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the MedPAC, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; H.R. 3138 Physician Payments Sunshine Act of 2009, a bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP; HR 3141 Strengthening the Health Care Safety Net Act of 2009, a bill to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 3152 Helping Seniors Choose their Medicare Drug Plan Act, a bill to amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs; S. 1423 Medicaid Birth Center Reimbursement Act, a bill to amend title XIX of the Social Security Act to require coverage under the Medicaid Program for freestanding birth center services; S. 1427 Department of Veterans Affairs Hospital Quality Report Card Act of 2009, a bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Department of Veterans Affairs Medical Centers, and for other purposes; H.R. 3172 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; H.R. 3184 Medicare Independent Living Act of 2009, a bill to amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; H.R. 3256 Rural Community Hospital Demonstration Extension Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; H.R. 3356 Medicare Beneficiary Freedom to Choose Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits; H.R. 3361 Medicare Patient Safeguards Act of 2009, a bill to provide a process for public comment and Medicare Evidence Development & Coverage Advisory Committee review of certain Medicare national coverage determinations, and for other purposes; HR 3369 and S.1521 Improve Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to require provider payments under Medicare and Medicaid to be made through direct deposit or electronic funds transfer (EFT) at insured depository institutions; S.1522 Outpatient Mental Health Modernization Act of 2009, a bill to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program; H.R. 3374 Medicare and Medicaid Access Project through Information Technology (MAP IT) Act, a bill to provide for a demonstration project relating to the impact of health information technology on chronic disease management under the Medicare and Medicaid programs; H.R. 3422 Medicare Support for Rural Hospitals Act, a bill to amend title XVIII of the Social Security Act to make temporary improvements to the Medicare inpatient payment adjustment for low-volume hospitals; H.R. 3430 DSH Collaborative Care Network Pilot Program Act of 2009, a bill to establish a Medicare DSH pilot program under which participants shall establish collaborative care networks to reduce the use of emergency departments, inpatient and other expensive resources of hospitals and other providers and provide more comprehensive and coordinated care to low-income individuals, including those without health insurance coverage, and to establish a Collaborative Care Network Center; Neal Letter to Pelosi, Opposition to the Independent Medicare Advisory Council (IMAC) and MedPAC Reform Act (HR 2718, S1110, S 1380); HR 3556 NO TITLE, a bill to require the Secretary of Health and Human Services to establish a self-referral disclosure protocol under the Medicare Program to enable health care providers of services and suppliers to disclose violations of section 1877 of the Social Security Act; S 1669 Equal Access to Medicare Options Act of 2009, a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy; HR 3631 Medicare Premium Fairness Act, a bill to amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010; HR 3653 Medicare Card Security Act of 2009, a bill to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; HR 3663 NO TITLE, a bill to amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; HR 3665 Ryan White Grantee Medicaid Payment Equity Act of 2009, a bill to amend title XIX of the Social Security Act to provide for payment for Medicaid services furnished by Ryan White part C grantees under a cost-based prospective payment system; HR 3675 National Quality Cancer Care Demonstration Project Act of 2009, a bill to improve the quality and cost effectiveness of cancer care to Medicare beneficiaries by establishing a national demonstration project; 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; Meeting with CMS re implementation of new requirements for insurance providers to report payment responsibility for Medicare Secondary Payer program; HR 3693 Ensuring the Future Physician Workforce Act of 2009, a bill to amend title XVIII of the Social Security Act to modify Medicare physician reimbursement policies to ensure a future physician workforce; HR 3961, HR 4154, S 1600 and Reid amendment 3305 Medicare Physician Payment Reform Act of 2009 and Statutory Pay-As-You-Go Act of 2009, a bill to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians and to reinstitute and update the Pay-As-You-Go requirement of budget neutrality on new tax and mandatory spending legislation, enforced by the threat of annual, automatic sequestration; HR 4250 Medicaid DSH Integrity Act, a bill to direct the Secretary of Health and Human Services to revise regulations implementing the statutory reporting and auditing requirements for the Medicaid disproportionate share hospital ("DSH") payment program to be consistent with the scope of the statutory provisions and avoid substantive changes to preexisting DSH policy; S 1776 Medicare Physician Fairness Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes; discussion with the HHS Office of the National Coordinator for Health Information Technology of hospital concerns around development of requirements for meaningful use of Electronic Health Records (EHR) to qualify for Medicare and Medicaid incentive payments for EHR development; S 3000 a bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months; HR 4213 American Workers, State, and Business Relief Act of 2010 a bill that includes an extension of the Recovery Acts increased Federal match for state Medicaid programs. The passed bill extends the increased FMAP through June 30, 2011, which is estimated to provide states with an additional $25.5 billion in FMAP; Letter to Pelosi and Reid expressing opposition to establishment of an Independent Payment Advisory Board (IPAB); Medicaid FMAP ARRA Extension Letter to Senator Reid to include an extension of federal Medicaid assistance to states in legislative proposals to increase employment and rebuild the nations economy; Space, Burgess, Stearns and Engel House Health IT letter and Klobuchar and Hatch Senate Health IT letter to CMS urging a modification of CMS proposed definition of and requirements for hospitals to become qualified as meaningful users of certified electronic health record (EHR) technology; S 3028 Medicare Mental Health Inpatient Equity Act, to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare program; HR 4872 The Health Care and Education Affordability Reconciliation Act of 2010, to provide for reconciliation pursuant to section 202 of the concurrent resolution on the budget for fiscal year 2010; Meetings with CMS to urge a different interpretation of the Medicare conditions of participation interpretive guidelines, as currently interpreted guidelines would require accreditation of each hospital as a standalone entity and require them to each have a separate governing body, medical staff, etc. in order to be accredited by the joint commission.

The Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act: the initiative attempts to address matters of recruitment/retention as it pertains to the Social Work profession, in addition to the establishment of a Social Work commission to study significant problems associated with the profession; (H.R.795/S.686); S. 686 (Mikulski), H.R. 795 (Towns) Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work. H. R. 4872 (Spratt) Health Care and Education Reconciliation Act of 2010 Support an Act to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010. The bill makes a number of health-related financing and revenue changes to the Patient Protection and Affordable Care Act enacted by H.R.3590 and modifies higher education assistance programs. H.R. 3962 (Dingell) Affordable Health Care for America Act Issues: Health System Reform Support a bill to provide affordable, guaranteed health coverage that will make Americans healthier and can never be taken away. H.R. 3590 (Rangel) The Patient Protection and Affordable Care Act Issues: Health System Reform. Support a bill to provide affordable, guaranteed health coverage that will make Americans healthier and can never be taken away. S. 71/H.R. 2058 Post Deployment Health Assessment Act of 2009. A bill to require mental health screenings for members of the Armed Forces who are deployed in connection with a contingency operation, and for other purposes. H.R. 2058 Post Deployment Health Assessment Act of 2009. A bill to require mental health screenings for members of the Armed Forces who are deployed in connection with a contingency operation, and for other purposes. H.R. 3200 Americas Affordable Health Choices Act. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 795 and S.686, Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act. Support establishing a Social Work Reinvestment Commission to address recruitment, retention, research, and reinvestment in the social work profession. S. 114, National Center for Social Work Research Act. Support establishing the National Center for Social Work Research as an agency of the National Institutes of Health (NIH) to conduct, support, and disseminate targeted research on social work methods and outcomes related to problems of significant social concern. S. 1403, Strengthen Social Work Training Act of 2009. Support ensuring 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. H.R. 1490, Teri Zenner Social Worker Safety Act Support establishing a grant program to assist in the provision of safety measures to protect social workers and other professionals who work with at-risk populations. H.R. 3590, Patient Protection and Affordable Care Act. Support a bill to provide affordable, quality health care for all Americans. The bill is the Senate vehicle for health care reform legislation. H.R. 4872, Health Care and Education Reconciliation Act of 2010. Support the bill that made a number of health-related financing and revenue changes to the Patient Protection and Affordable Care Act enacted by H.R. 3590 and modifies higher education assistance provisions. H.R.4594/ S.2982, International Violence Against Women Act of 2010. Support efforts to combat international violence against women and girls. H. RES. 1167, House Resolution for Professional Social Work Month and World Social Work Day. Support the resolution honoring the goals and ideals of Professional Social Work Month and World Social Work Day. S.1263/ H.R.3172, Senior Navigation and Planning Act of 2009. Support the effort to provide for advanced illness care management services for Medicare beneficiaries. SA 3453, Sessions-McCaskill Amendment to HR 1586 Opposed the amendment to impose statutory both defense and non-defense discretionary spending caps through FY 2013. H.R. 4123/S. 2809, Alzheimers Treatment and Caregiver Support Act. Support legislation that would provide grants to public and non-profit organizations to improve treatment for individuals with Alzheimers disease, and expand training and support services for caregivers. H.R. 2366, Cancer Drug Coverage Parity Act of 2009. Support legislation that would require a group health plan providing benefits for intravenously administered or injected cancer medications to provide no less favorable coverage for prescribed, orally administered anticancer medication used to kill or slow the growth of cancerous cells.

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

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

HR 27 Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the SCHIP for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465 a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a CMS Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Senator Schumer and Senator Roberts Letter eliminating IME Cuts CMS to withdraw the Capital IME cut that was included in last years Medicare IPPS rule; Letter to President Obama from Neal/ Tiberi on Capital IME Protect America's teaching hospitals asking him to withdraw a provision in the FY 2010 IPPS rule that would cut reimbursements to teaching hospitals. Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS); Working on legislation to amend the Medicare Recovery Audit Contractor Program; S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and(d) of section 114 of the Medicare, Medicaid, & SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letters and further discussions to CMS, Physician Supervision for Outpatient Service, resend policy changes requiring direct physician supervision for all PSO therapeutic Outpatient Service provided in and on hospital campus under Medicare, and withdraw change to minimize legal risk for years 2001-2009; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009, a bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals; HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262 Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the MedPAC on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 MedPAC Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the MedPAC, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; H.R. 3138 Physician Payments Sunshine Act of 2009, a bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP; HR 3141 Strengthening the Health Care Safety Net Act of 2009, a bill to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 3152 Helping Seniors Choose their Medicare Drug Plan Act, a bill to amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs; S. 1423 Medicaid Birth Center Reimbursement Act, a bill to amend title XIX of the Social Security Act to require coverage under the Medicaid Program for freestanding birth center services; S. 1427 Department of Veterans Affairs Hospital Quality Report Card Act of 2009, a bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Department of Veterans Affairs Medical Centers, and for other purposes; H.R. 3172 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; H.R. 3184 Medicare Independent Living Act of 2009, a bill to amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; H.R. 3256 Rural Community Hospital Demonstration Extension Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; H.R. 3356 Medicare Beneficiary Freedom to Choose Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits; H.R. 3361 Medicare Patient Safeguards Act of 2009, a bill to provide a process for public comment and Medicare Evidence Development & Coverage Advisory Committee review of certain Medicare national coverage determinations, and for other purposes; HR 3369 and S.1521 Improve Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to require provider payments under Medicare and Medicaid to be made through direct deposit or electronic funds transfer (EFT) at insured depository institutions; S.1522 Outpatient Mental Health Modernization Act of 2009, a bill to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program; H.R. 3374 Medicare and Medicaid Access Project through Information Technology (MAP IT) Act, a bill to provide for a demonstration project relating to the impact of health information technology on chronic disease management under the Medicare and Medicaid programs; H.R. 3422 Medicare Support for Rural Hospitals Act, a bill to amend title XVIII of the Social Security Act to make temporary improvements to the Medicare inpatient payment adjustment for low-volume hospitals; H.R. 3430 DSH Collaborative Care Network Pilot Program Act of 2009, a bill to establish a Medicare DSH pilot program under which participants shall establish collaborative care networks to reduce the use of emergency departments, inpatient and other expensive resources of hospitals and other providers and provide more comprehensive and coordinated care to low-income individuals, including those without health insurance coverage, and to establish a Collaborative Care Network Center; Neal Letter to Pelosi, Opposition to the Independent Medicare Advisory Council (IMAC) and MedPAC Reform Act (HR 2718, S1110, S 1380); HR 3556 NO TITLE, a bill to require the Secretary of Health and Human Services to establish a self-referral disclosure protocol under the Medicare Program to enable health care providers of services and suppliers to disclose violations of section 1877 of the Social Security Act; S 1669 Equal Access to Medicare Options Act of 2009, a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy; HR 3631 Medicare Premium Fairness Act, a bill to amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010; HR 3653 Medicare Card Security Act of 2009, a bill to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; HR 3663 NO TITLE, a bill to amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; HR 3665 Ryan White Grantee Medicaid Payment Equity Act of 2009, a bill to amend title XIX of the Social Security Act to provide for payment for Medicaid services furnished by Ryan White part C grantees under a cost-based prospective payment system; HR 3675 National Quality Cancer Care Demonstration Project Act of 2009, a bill to improve the quality and cost effectiveness of cancer care to Medicare beneficiaries by establishing a national demonstration project; 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; Meeting with CMS re implementation of new requirements for insurance providers to report payment responsibility for Medicare Secondary Payer program; HR 3693 Ensuring the Future Physician Workforce Act of 2009, a bill to amend title XVIII of the Social Security Act to modify Medicare physician reimbursement policies to ensure a future physician workforce; HR 3961Medicare Physician Payment Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians and to reinstitute and update the Pay-As-You-Go requirement of budget neutrality on new tax and mandatory spending legislation, enforced by the threat of annual, automatic sequestration; HR 4250 Medicaid DSH Integrity Act, a bill to direct the Secretary of Health and Human Services to revise regulations implementing the statutory reporting and auditing requirements for the Medicaid disproportionate share hospital ("DSH") payment program to be consistent with the scope of the statutory provisions and avoid substantive changes to preexisting DSH policy; S 1776 Medicare Physician Fairness Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes; discussion with the HHS Office of the National Coordinator for Health Information Technology of hospital concerns around development of requirements for meaningful use of Electronic Health Records (EHR) to qualify for Medicare and Medicaid incentive payments for EHR development.

HR 27 Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the State Children's Health Insurance Program for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465 a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a Centers for Medicare & Medicaid Services Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Senator Schumer and Senator Roberts Letter eliminating IME Cuts CMS to withdraw the Capital IME cut that was included in last years Medicare IPPS rule; Letter to President Obama from Neal/ Tiberi on Capital IME PROTECT AMERICAS TEACHING HOSPITALS, asking him to withdraw a provision in the FY 2010 IPPS rule that would cut reimbursements to teaching hospitals. Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS); Working on legislation to amend the Medicare Recovery Audit Contractor Program; S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, & SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letters and further discussions to CMS, Physician Supervision for Outpatient Service, resend policy changes requiring direct physician supervision for all PSO therapeutic Outpatient Service provided in and on hospital campus under Medicare, and withdraw change to minimize legal risk for years 2001-2009; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009, a bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals; HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262 Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the MedPAC on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 MedPAC Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the MedPAC, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; H.R. 3138 Physician Payments Sunshine Act of 2009, a bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP; HR 3141 Strengthening the Health Care Safety Net Act of 2009, a bill to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 3152 Helping Seniors Choose their Medicare Drug Plan Act, a bill to amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs; S. 1423 Medicaid Birth Center Reimbursement Act, a bill to amend title XIX of the Social Security Act to require coverage under the Medicaid Program for freestanding birth center services; S. 1427 Department of Veterans Affairs Hospital Quality Report Card Act of 2009, a bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Department of Veterans Affairs Medical Centers, and for other purposes; H.R. 3172 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; H.R. 3184 Medicare Independent Living Act of 2009, a bill to amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; H.R. 3256 Rural Community Hospital Demonstration Extension Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; H.R. 3356 Medicare Beneficiary Freedom to Choose Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits; H.R. 3361 Medicare Patient Safeguards Act of 2009, a bill to provide a process for public comment and Medicare Evidence Development & Coverage Advisory Committee review of certain Medicare national coverage determinations, and for other purposes; HR 3369 and S.1521 Improve Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to require provider payments under Medicare and Medicaid to be made through direct deposit or electronic funds transfer (EFT) at insured depository institutions; S.1522 Outpatient Mental Health Modernization Act of 2009, a bill to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program; H.R. 3374 Medicare and Medicaid Access Project through Information Technology (MAP IT) Act, a bill to provide for a demonstration project relating to the impact of health information technology on chronic disease management under the Medicare and Medicaid programs; H.R. 3422 Medicare Support for Rural Hospitals Act, a bill to amend title XVIII of the Social Security Act to make temporary improvements to the Medicare inpatient payment adjustment for low-volume hospitals; H.R. 3430 DSH Collaborative Care Network Pilot Program Act of 2009, a bill to establish a Medicare DSH pilot program under which participants shall establish collaborative care networks to reduce the use of emergency departments, inpatient and other expensive resources of hospitals and other providers and provide more comprehensive and coordinated care to low-income individuals, including those without health insurance coverage, and to establish a Collaborative Care Network Center; Neal Letter to Pelosi, Opposition to the Independent Medicare Advisory Council (IMAC) and MedPAC Reform Act (HR 2718, S1110, S 1380); HR 3556 NO TITLE, a bill to require the Secretary of Health and Human Services to establish a self-referral disclosure protocol under the Medicare Program to enable health care providers of services and suppliers to disclose violations of section 1877 of the Social Security Act; S 1669 Equal Access to Medicare Options Act of 2009, a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy; HR 3631 Medicare Premium Fairness Act, a bill to amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010; HR 3653 Medicare Card Security Act of 2009, a bill to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; HR 3663 NO TITLE, a bill to amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; HR 3665 Ryan White Grantee Medicaid Payment Equity Act of 2009, a bill to amend title XIX of the Social Security Act to provide for payment for Medicaid services furnished by Ryan White part C grantees under a cost-based prospective payment system; HR 3675 National Quality Cancer Care Demonstration Project Act of 2009, a bill to improve the quality and cost effectiveness of cancer care to Medicare beneficiaries by establishing a national demonstration project; 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 2758 - Special Needs Plans Reauthorization; HR 2945 - Medicare Advantage Truth in Advertising Act; HR 3172 - Senior Navigation and Planning Act; HR 6365 - Medicare Special Needs Plans Extension and Amendments Act of 2008; S 1150 - Advance Planning and Compassionate Care Act of 2009; S 1263 - Senior Navigation and Planning Act; S 1307 - Special Needs Plan Reauthorization; S 1544 - Medicare Quality Enhancement Act

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

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

Lobbied for a Senate sponsor for the Alzheimer's Treatment and Caregiver Support Act and for co-sponsors for H.R. 3043, the Medicare Adult Day Care Services Act of 2009." Urged cosponsorship and inclusion in Senate HELP, Senate Finance, and the House Tri-Committee health reform bills for the following proposals: S. 647 (and not yet introduced House version) of the "Nursing Home Transparancy and Improvement Act of 2009;" S. 245 and H.R. 468, "Retooling the Health Care Workforce;" S. 697 and H.R. 1721, Community Living Assistance Services and Supports (CLASS) Act;" S. 1004 and H.R. 2307, The RE-Aligning Care Act, and S. 1131 and H.R. 2560, The Independence at Home Act; H.R. 3191, "The Positive Aging Act;" and S. 1263, the Senior Navigation and Planning Act of 2009.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Engaged in discussions about the bill, possible changes to advance bill in health reform and it's provisions to balance Medicaid. Discussed chronic care issues and caregiver assessment in Medicaid. Discussed ways to provide better care coordination to dual eligibles and possible legislation (no bill). S.245/H.R. 468/S.434/H.R.468 Retooling the Health Care Workforce for an Aging America Act and possible amendment, the Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and shared endorsement letters. Discussed co-sponsors of Medicaid HCBS legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation and amendment on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed this bill and versions marked up in committee. Endorsed provisions in HELP and E&C Committee healthcare reform bills. S.1131/H.R.2560 Independence at Home Act - Endorsed and discussed AARP's support for this Medicare care coordination bill; and House Committee amendment and urged co-sponsorship. Discussed healthcare coverage for the 50-64 year old population age rating and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - To promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - To reduce unnecessary hospital readmissions, improving quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; endorsed committee amendment; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - To let Americans aged 55-64 who are otherwise without access to grup or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - To assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - To ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - To provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). H.R. 3293, Labor, HHS, Education and related agencies Appropriations bill for FY2010-Lobbied for funding for SSA, Older Americans Act programs, Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act), among other items (no bill numbers). S.750 Caring for an Aging america Act - Lobbied in support of legislation and discussed possible floor amendment.. S.1257/H.R.2852 Project 2020:Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. Responded to staff inquiry about AARP position on Medicare fraud bill; referred staff to appropriate AARP staff. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Discussed care coordination for dual eligibles and policy ideas to address this (no bill). Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1150 Advance Planning and Compassionate Care Act - Endorsed advance care planning legislation. S.1263 Senior Navigation and Planning Act legislation - discussed legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and urged cosponsors, advocated for amendment in committee. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act, America's Healthy Future Act (no Senate bill)- Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare.

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Engaged in discussions about the bill, possible changes to advance bill in health reform and it's provisions to balance Medicaid. Discussed chronic care issues and caregiver assessment in Medicaid. Discussed ways to provide better care coordination to dual eligibles and possible legislation (no bill). S.245/H.R. 468/S.434/H.R.468 Retooling the Health Care Workforce for an Aging America Act and possible amendment, the Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and shared endorsement letters. Discussed co-sponsors of Medicaid HCBS legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation and amendment on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed this bill and versions marked up in committee. Endorsed provisions in HELP and E&C Committee healthcare reform bills. S.1131/H.R.2560 Independence at Home Act - Endorsed and discussed AARP's support for this Medicare care coordination bill; and House Committee amendment and urged co-sponsorship. Discussed healthcare coverage for the 50-64 year old population age rating and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - To promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - To reduce unnecessary hospital readmissions, improving quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; endorsed committee amendment; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - To let Americans aged 55-64 who are otherwise without access to grup or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - To assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - To ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - To provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). H.R. 3293, Labor, HHS, Education and related agencies Appropriations bill for FY2010-Lobbied for funding for SSA, Older Americans Act programs, Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act), among other items (no bill numbers). S.750 Caring for an Aging america Act - Lobbied in support of legislation and discussed possible floor amendment.. S.1257/H.R.2852 Project 2020:Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. Responded to staff inquiry about AARP position on Medicare fraud bill; referred staff to appropriate AARP staff. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Discussed care coordination for dual eligibles and policy ideas to address this (no bill). Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1150 Advance Planning and Compassionate Care Act - Endorsed advance care planning legislation. S.1263 Senior Navigation and Planning Act legislation - discussed legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and urged cosponsors, advocated for amendment in committee. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act, America's Healthy Future Act (no Senate bill)- Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare.

HR 2609, Insurance Information Act, all provisions. HR 1880, National Insurance Consumer Protection Act, all provisions S 1263, HR 1571 Nonadmitted and Reinsurance Reform Act, provisions in Title II related to reinsurance reform. HR 3126, Consumer Financial Protection Agency Act, all provisions. HR 1754, S 664, Financial System Stabilization and Reform Act, all provisions. Administration proposals regarding financial services regulatory reform, including enhanced systemic risk oversight and new resolution authority.

Client expense: $1,550,000 · Firm income: Not reported

S. 711 Post Deployment Health Assessment Act of 2009 - A bill to require mental health screenings for members of the Armed Forces who are deployed in connection with a contingency operation, and for other purposes. H.R. 2058 Post Deployment Health Assessment Act of 2009 - A bill to require mental health screenings for members of the Armed Forces who are deployed in connection with a contingency operation, and for other purposes. H.R. 840 Military Domestic Violence and Sexual Assault Response Act - To reduce sexual assault and domestic violence involving members of the Armed Forces and their family members and partners through enhanced programs of prevention and deterrence, enhanced programs of victims services, and strengthened provisions for prosecution of assailants, and for other purposes. H.R. 3200 Americas Affordable Health Choices Act - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. The Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act: the initiative attempts to address matters of recruitment/retention as it pertains to the social work profession, in addition to the establishment of a social work commission to study significant problems with the profession; (H.R.795/S.686). H.R. 3200 Americas Affordable Health Choices Act Issue: Health Care Reform - Support a bill to reduce costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans. S. 1679 (Harkin) Affordable Health Choices Act Issue: Health Care Reform - Support a 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. 686 (Mikulski) H.R. 795 (Towns) Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act Issue: Health/Social Work Workforce Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work. S. 391 (Wyden/Bennett) The Healthy Americans Act Issues: Health System Reform. Monitor a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. HR.1321 (Eshoo) Healthy Americans Act Issues: Health System Reform. Monitor a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. Strengthen Social Work Training Act of 2009, S. 1403. Teri Zenner Social Worker Safety Act, H.R. 1490. Comprehensive Cancer Care Improvement Act, H.R.1844. H.R. 795 and S.686, Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act. Support establishing a Social Work Reinvestment Commission to address recruitment, retention, research, and reinvestment in the social work profession. S. 245 and H.R. 468, Retooling the Health Care Workforce for an Aging America. Support efforts 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. S. 114, National Center for Social Work Research Act. Support establishing the National Center for Social Work Research as an agency of the National Institutes of Health (NIH) to conduct, support, and disseminate targeted research on social work methods and outcomes related to problems of significant social concern. S. 717, 21st Century Cancer ALERT Act. Support modernizing cancer research, increasing access to preventative cancer services, providing cancer treatment and survivorship initiatives. S. 647, the Nursing Home Transparency and Improvement Act. Support efforts to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S.1263, Senior Navigation and Planning Act of 2009. Support effort to provide for advanced illness care management services for Medicare beneficiaries. S. 1403, Strengthen Social Work Training Act of 2009. Support ensuring 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. H.R. 1490, Teri Zenner Social Worker Safety Act. Support establishing a grant program to assist in the provision of safety measures to protect social workers and other professionals who work with at-risk populations. H.R.1844, Comprehensive Cancer Care Improvement Act Support efforts to provide coverage of comprehensive cancer care planning under the Medicare Program and improve the care furnished to individuals diagnosed with cancer by establishing a Medicare hospice care demonstration program and grants programs for cancer palliative care and symptom management programs, provider education, and related research. H.R. 3090, Health Equity and Accountability Act of 2009. Support the bill designed to improve the health of minority individuals. H.R.3200 America's Affordable Heath Choices Act of 2009. Support a bill to reduce costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans. S. (draft) Senate Health Education, Labor and Pensions Committee Health Care Reform draft bill - Affordable Health Choices Act Support a 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. (draft) Senate Finance Committee Health Care Reform draft bill - Americas Healthy Future Act Support a bill to lower costs and provide quality, affordable health care coverage.

On the Senate Finance Committees Chairmans Mark, Americas Healthy Future Act of 2009, contacts in support of addition of variable withhold financing method to avoid rationing. Contacts in support of the Chairmans mark anti-discrimination language as it related to Comparative Effectiveness Research. (continued) Contacts in support of extending the comparative effectiveness style anti-discrimination language to other portions of the mark. Contacts in support of Sen. Kyl amendment D2-125 and Sen. Roberts amendment D1-137 which would eliminate the 5% penalty for Medicare physicians in the top 10% of spending. Contacts in support of Kyl amendment 152 which would allow senior citizens to opt out of Medicare. Contacts to oppose Rockefeller amendments 207, 208, and 210, relating to advance care planning because: contains disincentive for balanced counseling and incentives to steer them toward rejection of treatment, including life-preserving treatment, lacks representatives of disability rights groups and groups who advocate for treatment without regard to patients quality of life, lacks continuing oversight and evaluation of created board, lacks protections for portability of advanced directives across states, lacked conscience protections, and made changes to Assisted Suicide Funding Restriction Act of 1997. Contacts to support Bunning Amendment D3-135 or Bunning Amendment D1-130 to require a Congressional vote in order to implement recommendations of the Medicare Commission. On S.1679, the Affordable Health Choices Act, contacts in support of the addition of variable withhold financing method to avoid rationing. Contacts in support of Enzi Amendment 210 to prohibit the community health insurance option from denying patients medical care needed to prevent their deaths or preserve or restore their health. Contacts in support of Enzi Amendment 271 to prohibit regulation that preclude plan or issuer from providing payment for a treatment or diagnostic procedure it chooses to cover, unless such treatment or procedure has been determined to be unsafe or dangerous. Contacts in support of Enzi Amendment 272 to prevent denial of care based on patient age, disability, medical dependency or quality of life. Contacts in support of Enzi Amendment 273 to prohibit regulations that preclude providers from providing or prescribing any treatment or diagnostic procedure that has not been determined to be unsafe or dangerous. Contacts in support of Enzi Amendment 274 to prohibit the Exchange from excluding qualified plans by: using premium price controls, excluding fee-for-service plans, or requiring plans to deny policyholders life-saving medical treatment. Contacts in support of Enzi Amendment 279 which would preserve the option of fee-for-service healthcare. Contacts in support of Enzi Amendment 280 which would prevent the denial of end of life care and which would prohibit the Exchange from excluding plans that choose not to limit access to therapies and treatment. Contacts in support of Enzi Amendment 283 which would prohibit the Secretary of Health and Human Services from setting payment rates for items and services that are medically necessary. Contacts in support of Enzi Amendment 284 which would prohibit the Secretary of Health and Human Services from limiting access to any therapies or treatments that are medically necessary. Contacts in support of Enzi Amendment 285 to prohibit the Secretary of Health and Human Services from limiting access to end of life care by allowing the public option to employ a pattern or practice of discrimination based on the age, disability or purported "quality of life" of the patient. Contacts regarding Sen. Hatch amendment 229 to ensure that taxpayer funds do not support or fund physician assisted suicide. Contacts regarding Sen. Coburn Amendment 237 that would ensure healthcare providers are not forced to participate in assisted suicide or discriminated against because they choose not to participate in assisted suicide. Contacts regarding Sen. Coburn amendment 220 for general conscience protection and protection against discrimination. On S. 1213, The Patient-Centered Outcomes Research Act of 2009, regarding comparative effectiveness standards in Medicare, worked to ensure that patients competence, age, expected length of life, present or predicted disability, degree of medical dependency, or quality of life will not be used as the basis for denial of Medicare benefits to patients against their wishes. On S. 1133, Empowering Medicare Patient Choices Act, supported the removal of language which creates an unacceptable disincentive for balanced counseling and assistance that genuinely attempts to elucidate patients values and preferences, and an incentive to steer them toward rejection of treatment, including life-preserving treatment. Urged the inclusion on advisory council of representatives of disability rights groups and groups who advocate for treatment without regard to patients quality of life. On S.1263 Senior Navigation and Planning Act of 2009, supported the removal of language which creates an unacceptable disincentive for balanced counseling and assistance that genuinely attempts to elucidate patients values and preferences, and an incentive to steer them toward rejection of treatment, including life-preserving treatment. Urged the inclusion on advisory board of representatives of disability rights groups and groups who advocate for treatment without regard to patients quality of life. Urged continuing oversight and evaluation by created board. Urged changes to provisions regarding portability of advanced directives across states. Urged the inclusion of conscience protections. (continued) On Senate 1150 Advance Planning and Compassionate Care Act of 2009, urged that a qualified oversight body make recommendations concerning various informational elements of the legislation. Opposed provision that would repeal provisions of the Assisted Suicide Funding Restriction Act. Sought the inclusion of protective language that would safeguard state modifications when they had adopted the Uniformed Health Care Decisions Act. On health care reform generally, contacts in effort to oppose rationing of health care and support the addition of variable withhold financing method to avoid rationing. U.S. House of Representatives On H.R. 3200, America's Affordable Health Choices Act of 2009, contacts in support of language to exclude rationing of health care. Contacts in support of language to prevent comparative effectiveness research from being used in making coverage decisions, determining reimbursement rates, or establishing incentive programs in ways that discriminatorily deny or limit health care based on age, present or predicted disability, or expected length of life. Contacts in support of prohibition of using quality adjusted life years (or other standards that discount the value of a period of life based on the patients present or predicted disability or quality of life) being employed in making coverage decisions, determining reimbursement rates, or establishing incentive programs. Contacts in support of the inclusion of Comparative Effectiveness panel members that represent disability rights organizations as well as represent organizations that advocate for the rights of patients to obtain treatment without regard to the patients quality of life. Contacts in support of prohibiting Commissioner from terminating qualified plans by: using premium price controls, excluding fee-for-service plans, or requiring plans to deny policyholders life-saving medical treatment. Contacts in support of prohibiting the Commissioner from implementing premium price controls. Contacts to support striking a section that would incent Medicare providers to limit treatment utilization. Contacts to support language that would ensure that neither the Exchange or the public insurance option employ a pattern or practice of discrimination based on the age, disability or purported "quality of life" of the patient. Contacts to support language to ensure that health benefits established as essential not be subject to denial to patients against their wishes on the basis of patients' age or expected length of life or of patients' present or predicted disability, degree of medical dependency, or quality of life. Contacts to support language that no health plan or health insurance issuer shall be forced to deny patients medical care needed to prevent their deaths or preserve or restore their health and no plan or issuer shall be prohibited from providing a treatment or diagnostic procedure it chooses to cover, unless such treatment or procedure has been determined to be unsafe, dangerous, or capable neither of preventing the patient's death nor of preserving or restoring the patient's health. On health care reform generally, contacts in effort to oppose rationing of health care and support the addition of variable withhold financing method to avoid rationing. Executive Office of the President U.S. Senate Contacts in support of introduction of language into the Senate Finance Committees Chairmans Mark, Americas Healthy Future Act of 2009, to prevent comparative effectiveness research from being used in making coverage decisions, determining reimbursement rates, or establishing incentive programs in ways that discriminatorily deny or limit health care based on age, present or predicted disability, or expected length of life. Contacts in support of prohibition of using quality adjusted life years (or other standards that discount the value of a period of life based on the patients present or predicted disability or quality of life) being employed in making coverage decisions, determining reimbursement rates, or establishing incentive programs.

U.S. Senate On the Senate Finance Committees Chairmans Mark, Americas Healthy Future Act of 2009, contacts in support of addition of variable withhold financing method to avoid rationing. Contacts in support of the Chairmans mark anti-discrimination language as it related to Comparative Effectiveness Research. (continued) Contacts in support of extending the comparative effectiveness style anti-discrimination language to other portions of the mark. Contacts in support of Sen. Kyl amendment D2-125 and Sen. Roberts amendment D1-137 which would eliminate the 5% penalty for Medicare physicians in the top 10% of spending. Contacts in support of Kyl amendment 152 which would allow senior citizens to opt out of Medicare. Contacts to oppose Rockefeller amendments 207, 208, and 210, relating to advance care planning because: contains disincentive for balanced counseling and incentives to steer them toward rejection of treatment, including life-preserving treatment, lacks representatives of disability rights groups and groups who advocate for treatment without regard to patients quality of life, lacks continuing oversight and evaluation of created board, lacks protections for portability of advanced directives across states, lacked conscience protections, and made changes to Assisted Suicide Funding Restriction Act of 1997. Contacts to support Bunning Amendment D3-135 or Bunning Amendment D1-130 to require a Congressional vote in order to implement recommendations of the Medicare Commission. On S.1679, the Affordable Health Choices Act, contacts in support of the addition of variable withhold financing method to avoid rationing. Contacts in support of Enzi Amendment 210 to prohibit the community health insurance option from denying patients medical care needed to prevent their deaths or preserve or restore their health. Contacts in support of Enzi Amendment 271 to prohibit regulation that preclude plan or issuer from providing payment for a treatment or diagnostic procedure it chooses to cover, unless such treatment or procedure has been determined to be unsafe or dangerous. Contacts in support of Enzi Amendment 272 to prevent denial of care based on patient age, disability, medical dependency or quality of life. Contacts in support of Enzi Amendment 273 to prohibit regulations that preclude providers from providing or prescribing any treatment or diagnostic procedure that has not been determined to be unsafe or dangerous. Contacts in support of Enzi Amendment 274 to prohibit the Exchange from excluding qualified plans by: using premium price controls, excluding fee-for-service plans, or requiring plans to deny policyholders life-saving medical treatment. Contacts in support of Enzi Amendment 279 which would preserve the option of fee-for-service healthcare. Contacts in support of Enzi Amendment 280 which would prevent the denial of end of life care and which would prohibit the Exchange from excluding plans that choose not to limit access to therapies and treatment. Contacts in support of Enzi Amendment 283 which would prohibit the Secretary of Health and Human Services from setting payment rates for items and services that are medically necessary. Contacts in support of Enzi Amendment 284 which would prohibit the Secretary of Health and Human Services from limiting access to any therapies or treatments that are medically necessary. Contacts in support of Enzi Amendment 285 to prohibit the Secretary of Health and Human Services from limiting access to end of life care by allowing the public option to employ a pattern or practice of discrimination based on the age, disability or purported "quality of life" of the patient. Contacts regarding Sen. Hatch amendment 229 to ensure that taxpayer funds do not support or fund physician assisted suicide. Contacts regarding Sen. Coburn Amendment 237 that would ensure healthcare providers are not forced to participate in assisted suicide or discriminated against because they choose not to participate in assisted suicide. Contacts regarding Sen. Coburn amendment 220 for general conscience protection and protection against discrimination. On S. 1213, The Patient-Centered Outcomes Research Act of 2009, regarding comparative effectiveness standards in Medicare, worked to ensure that patients competence, age, expected length of life, present or predicted disability, degree of medical dependency, or quality of life will not be used as the basis for denial of Medicare benefits to patients against their wishes. On S. 1133, Empowering Medicare Patient Choices Act, supported the removal of language which creates an unacceptable disincentive for balanced counseling and assistance that genuinely attempts to elucidate patients values and preferences, and an incentive to steer them toward rejection of treatment, including life-preserving treatment. Urged the inclusion on advisory council of representatives of disability rights groups and groups who advocate for treatment without regard to patients quality of life. On S.1263 Senior Navigation and Planning Act of 2009, supported the removal of language which creates an unacceptable disincentive for balanced counseling and assistance that genuinely attempts to elucidate patients values and preferences, and an incentive to steer them toward rejection of treatment, including life-preserving treatment. Urged the inclusion on advisory board of representatives of disability rights groups and groups who advocate for treatment without regard to patients quality of life. Urged continuing oversight and evaluation by created board. Urged changes to provisions regarding portability of advanced directives across states. Urged the inclusion of conscience protections. On Senate 1150 Advance Planning and Compassionate Care Act of 2009, urged that a qualified oversight body make recommendations concerning various informational elements of the legislation. Opposed provision that would repeal provisions of the Assisted Suicide Funding Restriction Act. Sought the inclusion of protective language that would safeguard state modifications when they had adopted the Uniformed Health Care Decisions Act. On health care reform generally, contacts in effort to oppose rationing of health care and support the addition of variable withhold financing method to avoid rationing. U.S. House of Representatives On H.R. 3200, America's Affordable Health Choices Act of 2009, contacts in support of language to exclude rationing of health care. Contacts in support of language to prevent comparative effectiveness research from being used in making coverage decisions, determining reimbursement rates, or establishing incentive programs in ways that discriminatorily deny or limit health care based on age, present or predicted disability, or expected length of life. Contacts in support of prohibition of using quality adjusted life years (or other standards that discount the value of a period of life based on the patients present or predicted disability or quality of life) being employed in making coverage decisions, determining reimbursement rates, or establishing incentive programs. Contacts in support of the inclusion of Comparative Effectiveness panel members that represent disability rights organizations as well as represent organizations that advocate for the rights of patients to obtain treatment without regard to the patients quality of life. Contacts in support of prohibiting Commissioner from terminating qualified plans by: using premium price controls, excluding fee-for-service plans, or requiring plans to deny policyholders life-saving medical treatment. Contacts in support of prohibiting the Commissioner from implementing premium price controls. Contacts to support striking a section that would incent Medicare providers to limit treatment utilization. Contacts to support language that would ensure that neither the Exchange or the public insurance option employ a pattern or practice of discrimination based on the age, disability or purported "quality of life" of the patient. Contacts to support language to ensure that health benefits established as essential not be subject to denial to patients against their wishes on the basis of patients' age or expected length of life or of patients' present or predicted disability, degree of medical dependency, or quality of life. Contacts to support language that no health plan or health insurance issuer shall be forced to deny patients medical care needed to prevent their deaths or preserve or restore their health and no plan or issuer shall be prohibited from providing a treatment or diagnostic procedure it chooses to cover, unless such treatment or procedure has been determined to be unsafe, dangerous, or capable neither of preventing the patient's death nor of preserving or restoring the patient's health. On health care reform generally, contacts in effort to oppose rationing of health care and support the addition of variable withhold financing method to avoid rationing. Executive Office of the President U.S. Senate Contacts in support of introduction of language into the Senate Finance Committees Chairmans Mark, Americas Healthy Future Act of 2009, to prevent comparative effectiveness research from being used in making coverage decisions, determining reimbursement rates, or establishing incentive programs in ways that discriminatorily deny or limit health care based on age, present or predicted disability, or expected length of life. Contacts in support of prohibition of using quality adjusted life years (or other standards that discount the value of a period of life based on the patients present or predicted disability or quality of life) being employed in making coverage decisions, determining reimbursement rates, or establishing incentive programs.

H.R.3200: America's Affordable Health Choices Act of 2009 Americas Healthy Future Act S.1679: The Affordable Health Choices Act -Medicare Advantage -Medicare Special Needs Plans -Medicare Part D -Medicaid Managed Care -Administrative Simplification S.1263: Senior Navigation and Planning Act of 2009

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

HR 3200 Affordable Health Choices Act S.__ Affordable Health Choices Act "Senior Planning and Navigation Act" S 1263 Health Care Reform

Client expense: Not reported · Firm income: $54,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3200 Affordable Health Choices Act S.__ Affordable Health Choices Act "Senior Planning and Navigation Act" S 1263 Health Care Reform

Client expense: Not reported · Firm income: $54,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

HR 3200 Affordable Health Choices Act S.__ Affordable Health Choices Act "Senior Planning and Navigation Act" S 1263 Health Care Reform

Client expense: Not reported · Firm income: Not reported

HR 3200 Affordable Health Choices Act S.__ Affordable Health Choices Act "Senior Planning and Navigation Act" S 1263 Health Care Reform

Client expense: Not reported · Firm income: Not reported

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

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

HR 27Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the State Children's Health Insurance Program for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465,a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a Centers for Medicare & Medicaid Services Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Senator Schumer and Senator Roberts Letter eliminating IME Cuts CMS to withdraw the Capital IME cut that was included in last years Medicare IPPS rule; Letter to President Obama from Neal/ Tiberi on Capital IME PROTECT AMERICAS TEACHING HOSPITALS, asking him to withdraw a provision in the FY 2010 IPPS rule that would cut reimbursements to teaching hospitals. Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS).Working on legislation to amend the Medicare Recovery Audit Contractor Program. S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare Program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letter to CMS, Physician Supervision for Outpatient Service, Resend policy changes requiring PSO therapeutic Service in and on hospital campus. Withdraw it to minimize legal risk; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009A bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the Medicare Payment Advisory Commission on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy.

The Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act: the initiative attempts to address matters of recruitment/retention as it pertains to the social work profession, in addition to the establishment of a social work commission to study significant problems associated with the profession; (H.R.795/S.686); S. (draft) "Affordable Health Choices Act" Issue: health Care Reform: Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work; HR. (draft) House Tri-Committee Health Reform Discussion Draft Issue: Health Care Reform: Support a bill to reduce costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans; S. 686 (Mikulski) Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act Issue: Health/Social Work Workforce: Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work; HR. 795 (Towns) Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act Issue: Health/Social Work Workforce: Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work; S. 711 Post Deployment Health Assessment Act of 2009. A bill to require mental health screenings for members of the Armed Forces who are deployed in connection with a contingency operation, and for other purposes; H.R. 2058 Post Deployment Health Assessment Act of 2009: A bill to require mental health screenings for members of the Armed Forces who are deployed in connection with a contingency operation, and for other purposes; H.R. 840 Military Domestic Violence and Sexual Assault Response Act: To reduce sexual assault and domestic violence involving members of the Armed Forces and their family members and partners through enhanced programs of prevention and deterrence, enhanced programs of victims services, and strengthened provisions for prosecution of assailants, and for other; HCR: Health Issues H.R. 795 and S.686, Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act: Support establishing a Social Work Reinvestment Commission to address recruitment, retention, research, and reinvestment in the social work profession; S. 245 and H.R. 468, Retooling the Health Care Workforce for an Aging America: Support efforts 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; S. 114, National Center for Social Work Research Act: Support establishing the National Center for Social Work Research as an agency of the National Institutes of Health (NIH) to conduct, support, and disseminate targeted research on social work methods and outcomes related to problems of significant social concern; S. 717, 21st Century Cancer ALERT Act: Support modernizing cancer research, increasing access to preventative cancer services, providing cancer treatment and survivorship initiatives; S. 647, the Nursing Home Transparency and Improvement Act: Support efforts to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities; S.1263, Senior Navigation and Planning Act of 200: Support effort to provide for advanced illness care management services for Medicare beneficiaries; S. 1403, Strengthen Social Work Training Act of 2009: Support ensuring 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; H.R. 1490, Teri Zenner Social Worker Safety Act: Support establishing a grant program to assist in the provision of safety measures to protect social workers and other professionals who work with at-risk populations; H.R.1844, Comprehensive Cancer Care Improvement Act Support efforts to provide coverage of comprehensive cancer care planning under the Medicare Program and improve the care furnished to individuals diagnosed with cancer by establishing a Medicare hospice care demonstration program and grants programs for cancer palliative care and symptom management programs, provider education, and related research; H.R. 3090, Health Equity and Accountability Act of 2009: Support the bill designed to improve the health of minority individuals; H.R. (draft) House Tri-Committee Health Reform Discussion Draft Support a bill to reduce costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans; S. (draft) Senate Health, Education, Labor and Pensions Committee Health Care Reform draft bill - Affordable Health Choices Act Support a 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. 2 - Children's Health Insurance Program Reauthorization Act; H.R. 2638 - Consolidated Security, Disaster Assistance, and Continuing Appropriations Act; H.R. 2642 - Supplemental Appropriations for FY 2008; H.R. 2945 - Medicare Advantage Truth in Advertising Act; H.R. 3172 - Senior Navigation and Planning Act; H.R. 4296 - Medicare Electronic Medication and Safety Protection Act; H.R. 5613 - Protecting the Medicaid Safety Net Act; H.R. 6331 - Medicare Improvements for Patients and Providers Act of 2008; H.R. 6365 - Medicare Special Needs Plans Extension and Amendments Act of 2008; S. 1150 - Advance Planning and Compassionate Care Act of 2009; S. 1263 - Senior Navigation and Planning Act; S. 1507 - Access to Medicare Data Act; S. 1544 - Medicare Quality Enhancement Act; S. 1954 - Pharmacy Access Improvement Act; S. 2408 - Medicare Electronic Medication and Safety Protection Act; S. 3101 - Medicare Improvements for Patients and Providers Act of 2008; S. 3236 - The Medicare and Medicaid Extensions Act of 2008; S. 3560 - QI Program Supplemental Funding Act of 2008; H.R. 2758 - Special Needs Plans Reauthorization; S. 1307 - Special Needs Plans Reauthorization

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

Lobbied for sponsors for the Alzheimer's Treatment and Caregiver Support Act and for co-sponsors for H.R. 2987, the "Cure and Understanding Through Research for Alzheimer's Act of 2009." Urged cosponsorship and inclusion in health reform for the following proposals: S. 647 (and not yet introduced House version) of the "Nursing Home Transparancy and Improvement Act of 2009;" S. 245 and H.R. 468, "Retooling the Health Care Workforce;" S. 697 and H.R. 1721, Community Living Assistance Services and Supports (CLASS) Act;" S. 1004 and H.R. 2307, The RE-Aligning Care Act, and S. 1131 and H.R. 2560, The Independence at Home Act; H.R. 3191, "The Positive Aging Act;" S. 1263, the Senior Navigation and Planning Act of 2009; and H.R. 3043, the Medicare Adult Day Care Services Act of 2009."

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2609, Insurance Information Act, all provisions. HR 1880, National Consumer Protection Act, all provisions. S 1263, HR 1571, Nonadmitted and Reinsurance Reform Act, provisions in Title II related to reinsurance reform. HR 1754, S 664, Financial System Stabilization and Reform Act, all provisions. HR 1705, S 566 Financial Product Safety Commission Act Administration proposals regarding financial services regulatory reform, including proposals to create an Office of National Insurance, Consumer Financial Protection Agency, enhanced systemic risk oversight and new resolution authority for bank holding companies and other financial institutions.

Client expense: $1,460,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Engaged in discussions about the bill and it's provisions to balance Medicaid. Discussed ideas to balance state long-term care systems including enhanced FMAP provisions for Medicaid (no bill). Discussed chronic care issues and caregiver assessment in Medicaid. Provided feedback on Medicare Realigning CARE Act (?) chronic care coordinating HCBS and provided feedback on draft proposals (no bill). Discussed challenges to replication of the PACE program. Discussed lessons learned from PACE that could be applicable to dual eligible SNPs (no bill). Discussed ways to provide better care coordination to dual eligibles and possible legislation. S.647/H.R.7128, Nursing Home Transparency and Quality of Care Improvement Act - Discussed reintroduction of the Nursing Home Transparency and Improvement Act in the House and discussed feedback on the bill's provisions. Also discussed provisions of S.647 Nursing Home Quality of Care and Transparency and Improvement Act (S.647). S.245/H.R. 468/S.434/H.R.468 Retooling the Health Care Workforce for an Aging America Act, the Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and shared endorsement letters. Discussed co-sponsors of Medicaid HCBS legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Endorsed legislation on criminal background checks for employees of long-term care providers and specific bill provisions. Discussed system delivery reform in health care reform and logistics for testimony. Submitted delivery system reform testimony and comments to Finance Committee. Discussed health care reform substance and process in Finance and HELP Committees (no bill). Discussed Budget Committee letter on health care reform, shared AARP's position on the budget and health care reform. (no bill) S. 697/H.R.1721, Class Act - Discussed this bill, (next steps, scoring, actual analysis, testimony, markup and AARP position, S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for Medicare care coordination bill; a Hill briefing, bill reintroduction, and urged co-sponsorship. Discussed healthcare coverage for the 50-64 year old population and scheduled meetings for volunteers to share their coverage stories (no bill). S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - To promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - To reduce unnecessary hospital readmissions, improving quality for Medicare beneficiaries, and reducing wasteful spending in Medicare. S. 960, Medicare Early Access Act of 2009 - To let Americans aged 55-64 who are otherwise without access to grup or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - To assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - To ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - To provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population. Labor, HHS, Education and related agencies Appropriations bill for FY2010-Lobbied for funding for SSA, Older Americans Act programs, Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act), among other items (no bill numbers). S.1004 Re-Aligning CARE Act - Discussed feedback on draft Re-aligning CARE Act and urged Sen. Lincoln to sponsor a bill to establish a transitional care benefit in Medicare. Discussed AARP proposal for a Medicare transitional care benefit (no bill number). Set up meeting with MedPAC staff to discuss Medicare transitional care benefit; meeting subsequently held. S.750 Caring for an Aging america Act - Lobbied in support of legislation. Discussed concerns over HHA regulation which would make it more difficult for state surveyors to share information about their surveys of nursing homes. (no bill) S.1257/H.R.2852 Project 2020:Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Inquired regarding use of Medicaid stimulus funds for an enhanced match in the Money Follows the Person Demonstration Program. Set up meetings to discuss AARP Health Care Reform priorities. Discussed Medicare physician payment issues and SGR. Inquired about information regarding a Medicare waiver and five New England states. Responded to staff inquiry about AARP position on Medicare fraud bill; referred staff to appropriate AARP staff. Discussed idea of an annual physical for Medicare beneficiaries. S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. Discussed care coordination for dual eligibles and policy ideas to address this. Provided information to help educate family caregivers about benefits under Medicare and Medicaid. (no bill) Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1150 Advance Planning and Compassionate Care Act - Discussed concerns on draft advance care planning legislation. S.1263 Senior Navigation and Planning Act - Discussed legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation.