Medicare Specialty Care Improvement and Protection Act of 2009

Public Law No: 111-152 (formerly HR4872): Health Care and Education Reconciliation Act of 2010 HR904, S547 Medicaid Prescription Drug Rebate Equalization Act of 2009: To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. HR2758, S1307 Medicare Specialty Care Improvement and Protection Act of 2009: 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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 684, Medicare Prescription Drug Savings and Choice Act (Berry) Part D reforms; H.R. 904, Medicaid Prescription Drug Rebate Equalization Act (Stupak) Medicaid drug costs; H.R. 1407, Medicare Part D Home and Community Services Copayment Equity Act (Doggett) Part D cost sharing; H.R. 1670, Community Choice Act (Davis) Medicaid coverage; H.R. 1832, Medicare Prescription Drug Affordability Act (Wexler) Part D reforms; (cont.) MMM (Legislative) H.R. 2501, Medicare Cost Contract Extension and Refinement Act (Pomeroy) Medicare cost plans; H.R. 2686, Medicare Advantage Payments (Israel) Medicare Advantage benchmark adjustments; H.R. 2688, Empowered at Home Act (Pallone) home and community-based services under Medicaid; H.R. 2700, Prescription Coverage Now Act (Doggett) low-income assistance under Medicare Part D; H.R. 2718, MedPAC Reform Act (Cooper) implementation of Medicare payment policies; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; H.R. 2847, Jobs for Main Street Act (Mollohan) Medicaid FMAP; H.R. 2860, Medicare Drug Savings Through Choice Act (Murphy) Part D reforms; H.R. 3152, Helping Seniors Choose their Medicare Drug Plan Act (Holt) Part D enrollment; H.R. 3200, Americas Affordable Health Choices Act (Dingell) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; H.R. 3418, Medicare Prescription Drug Cost Equalization Act (Ellsworth) Part D exceptions process; H.R. 3590, Patient Protection and Affordable Care Act (Reid) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; H.R. 3631, Medicare Premium Fairness Act (Titus) Part B premiums; H.R. 3961, Medicare Physician Payment Reform Act (Dingell) Medicare physician payment; H.R. 3962, Americas Affordable Health Choices Act (Dingell) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; H.R. 4213, Tax Extenders Act (Rangel) MA Special Needs Plans, Cost Plans, Medicare physician payment, Medicaid FMAP; H.R. 4263 (Baldwin) Medicaid FMAP extension; H.R. 4691, Temporary Extension Act (Rangel) Medicare physician payment; H.R. 4752, Medicare Prescription Drug Price Negotiation Act (Welch) HHS Secretarys role in negotiating Part D drug prices; H.R. 4851, Continuing Extension Act (Levin) Medicare physician payment; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding; H.R. 4917 (Schauer) Medicare Part D formulary changes; H.J.Res. 45 Medicare physician payment, pay-as-you-go budget rules; S. 75, Generics First Act (Kohl) Part D reforms; S. 266, Medicare Prescription Drug Gap Reduction Act (Nelson) Part D reforms; S. 330, Medicare Prescription Drug Savings and Choice Act (Durbin) Part D reforms; S. 534, Home and Community Services Copayment Equity Act (Nelson) Part D reforms; S. 547, Drug Rebate Equalization Act (Bingaman) Medicaid drug costs; S. 677, REPAIR Act (Ensign) means-testing Part D premiums; S. 683, Community Choice Act (Harkin) Medicaid coverage; S. 960, Medicare Early Access Act (Rockefeller) Medicare buy-in option; S. 1079, Medicare Cost Contract Extension and Refinement Act (Klobuchar) Medicare cost plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans; S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies; S. 1634, Medicare Prescription Drug Coverage Improvement Act (Rockefeller) government operated Part D plan, dual eligibles; S. 1669, Equal Access to Medicare Options Act (Kerry) guaranteed issue Medigap, Medicare Advantage enrollment; S. 1776, Medicare Physician Fairness Act (Stabenow) Medicare physician payment; S. 1796, Americas Healthy Future Act (Baucus) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform; S. 2949, (Baucus) Medicaid QI Program funding; S. 3000 (Rockefeller) Medicaid FMAP extension; S. 3153, Continuing Extension Act (Grassley) Medicare physician payment MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, data, and audit issues, bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

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

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

H.R. 2758 - The Medicare Speciality Care Improvement and Protection Act of 2009- Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals S. 1307 - Medicare Special Needs Plans - Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals. H.R. 904 - Medicaid Prescription Drug Rebate Equalization Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. S. 547 - Medicaid Prescription Drug Rebate Equalization Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. H.R. 3200 - America's Affordable Health Choices Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. S. 1679 - The Affordable Health Choices Act - Medicaid Drug Rebate equalization for managed care organizations. Unnumbered Bill - America's Healthy Future Act 2009 - Medicaid Drug Rebate equalization for managed care organizations. H.R. 3962 - Affordable Health Care for America Act - health care reform legislation - Medicaid Drug Rebate equalization for managed care organizations. H.R. 3590 - The Patient Protectin and Affordable Care Act - heatlh care reform legislation - Medicaid Drug Rebate equalization for managed care organizations.

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

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

HR 2758, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage, special needs plans; HR 3200, America's Affordable Health Choices Act - Medicare Advantage, special needs plans, Medicare FFS payment reform; HR 3590, Patient Protection and Affordable Care Act - Medicare Advantage, special needs plans, Medicare FFS payment reform; HR 3962, Affordable Health Care for America Act - Medicare Advantage, special needs plans, Medicare FFS payment reform; HR 4213, Tax Extenders Act - Medicare Advantage, special needs plans, Medicare physician payment; HR 4872, Health Care and Education Reconciliation Act - changes to Medicare Advantage funding; S 1307, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage, special needs plans; S 1796, America's Healthy Future Act - Medicare Advantage, special needs plans, Medicare FFS payment reform

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

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

HR 3200, America's Affordable Health Choices Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; HR 3590, Patient Protection and Affordable Care Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 3961, Medicare Physician Payment Reform Act - Medicare physician payment; HR 3962, Affordable Health Care for America Act - Medicare Advantage, Part D, special needs plans , Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 4213, Tax Extenders Act - Medicare Advantage, special needs plans, cost plans, Medicare physician payment, Medicaid FMAP; HR 4691, Temporary Extension Act - Medicare physician payment; HR 4851, Continuing Extension Act - Medicare physician payment; HR 4872, Health Care and Education Reconciliation Act - changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding; HR Res 45 - Medicare physician payment, pay-as-you-go rules; S 960, Medicare Early Access Act - Medicare buy-in option; S 1307, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage special needs plans; S 1380, MedPAC Reform Act - implementation of Medicare payment policies; S 1796, America's Healthy Future Act - Medicare Advantage, Part D, special needs plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform;

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

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

HR 2758, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage, special needs plans; HR 3200, America's Affordable Health Choices Act - Medicare Advantage, special needs plans, Medicare FFS payment reform; HR 3590, Patient Protection and Affordable Care Act - Medicare Advantage, special needs plans, Medicare FFS payment reform; HR 3962, Affordable Health Care for America Act - Medicare Advantage, special needs plans, Medicare FFS payment reform; HR 4213, Tax Extenders Act - Medicare Advantage, special needs plans, Medicare physician payment; HR 4872, Health Care and Education Reconciliation Act - changes to Medicare Advantage funding; S 1307, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage, special needs plans; S 1796, America's Healthy Future Act - Medicare Advantage, special needs plans, Medicare FFS payment reform

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

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

HR 3200, America's Affordable Health Choices Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; HR 3590, Patient Protection and Affordable Care Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 3961, Medicare Physician Payment Reform Act - Medicare physician payment; HR 3962, Affordable Health Care for America Act - Medicare Advantage, Part D, special needs plans , Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 4213, Tax Extenders Act - Medicare Advantage, special needs plans, cost plans, Medicare physician payment, Medicaid FMAP; HR 4691, Temporary Extension Act - Medicare physician payment; HR 4851, Continuing Extension Act - Medicare physician payment; HR 4872, Health Care and Education Reconciliation Act - changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding; HR Res 45 - Medicare physician payment, pay-as-you-go rules; S 960, Medicare Early Access Act - Medicare buy-in option; S 1307, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage special needs plans; S 1380, MedPAC Reform Act - implementation of Medicare payment policies; S 1796, America's Healthy Future Act - Medicare Advantage, Part D, special needs plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform;

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

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

HR 3200, America's Affordable Health Choices Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; HR 3590, Patient Protection and Affordable Care Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 3961, Medicare Physician Payment Reform Act - Medicare physician payment; HR 3962, Affordable Health Care for America Act - Medicare Advantage, Part D, speical needs plans , Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 4213, Tax Extenders Act - Medicare Advantage, special needs plans, cost plans, Medicare physician payment, Medicaid FMAP; HR 4691, Temporary Extension Act - Medicare physician payment; HR 4851, Continuing Extension Act - Medicare physician payment; HR 4872, Health Care and Education Reconciliation Act - changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding; HR Res 45 - Medicare physician payment, pay-as-you-go rules; S 960, Medicare Early Access Act - Medicare buy-in option; S 1307, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage special needs plans; S 1380, MedPAC Reform Act - implementation of Medicare payment policies; S 1796, America's Healthy Future Act - Medicare Advantage, Part D, special needs plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform;

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

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

HR 3200, America's Affordable Health Choices Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; HR 2758, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage, special needs plans; HR 3590, Patient Protection and Affordable Care Act - Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 3961, Medicare Physician Payment Reform Act - Medicare physician payment; HR 3962, Affordable Health Care for America Act - Medicare Advantage, Part D, special needs plans , Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; HR 4213, Tax Extenders Act - Medicare Advantage, special needs plans, cost plans, Medicare physician payment, Medicaid FMAP; HR 4691, Temporary Extension Act - Medicare physician payment; HR 4851, Continuing Extension Act - Medicare physician payment; HR 4872, Health Care and Education Reconciliation Act - changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding; HR Res 45 - Medicare physician payment, pay-as-you-go rules; S 960, Medicare Early Access Act - Medicare buy-in option; S 1307, Medicare Specialty Care Improvement and Protection Act - Medicare Advantage special needs plans; S 1380, MedPAC Reform Act - implementation of Medicare payment policies; S 1796, America's Healthy Future Act - Medicare Advantage, Part D, special needs plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform;

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

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

Medicare Advantage, Part D, special needs plans, medicare cost plans, medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3962, America's Affordable Health Choices Act. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3590, An act entitled The Patient Protection and Affordable Care Act. Changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding - HR 4872, Health Care and Education Reconciliation Act of 2010. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re this issue; HR 3590, An act entitled The Patient Protection and Affordable Care Act. *Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. *Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. *Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, America's Affordable Health Choices Act. *Medicare physician payments - HR 3961, Medicare Physician Payment Reform Act of 2009; HR 4691, Temporary Extension Act of 2010; HR 4851, Continuing Extension Act of 2010; S 3153, Continuing Extension Act of 2010. *MA special needs plans, cost plans, Medicare physician payments, Medicaid FMAP - HR 4213, American Workers, State, and Business Relief Act of 2010. *Medicaid FMAP extension - HR 4263, State Medicaid Assistance Extension Act of 2009; 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. *Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. *Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. *Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. *Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. *Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income 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. *Implementation of Medicare payment policies - HR 2718, 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 1380, 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. *Medicare Advantage special needs plans - HR 2758, 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; S 1307, 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. *Home and community-based services under Medicaid - HR 2688, 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. *Part D enrollment - HR 3152, 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. *Part D exceptions process, HR 3418, To amend part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs. *Part B premiums - HR 3631, 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. *Government-operated Part D plan, dual eligibles - S 1634, A bill to amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs. *Guaranteed-issue MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. *Medicaid FMAP - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes. *Medicare physician payments - S 1776, 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. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform - S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. *HHS Secretary's role in negotiating Part D drug prices - HR 4752, Medicare Prescription Drug Price Negotiation Act of 2010. *Medicare Part D formulary changes - HR 4917, To amend part D of title XVIII of the Social Security Act to prohibit mid-year changes in the formularies of Medicare Part D plans. *Medicare physician payment, pay-as-you-go budget rules - HJRes 45, Increasing the statutory limit on the public debt. *Medicaid QI Program funding - S 2949, Emergency Aid to American Survivors of the Haiti Earthquake Act.

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

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

Attempted to amend legislation to prevent physician fee cuts -- to obtain Congressional authority for CMS to modify 2011 Medicare Advantage payments related to physician services, consistent with the 2011 physician fee schedule that will result if Congress passes legislation to halt scheduled cuts in physician fees through December 31, 2011. This included HR 4213, the Tax Extenders Act of 2009. Issues related to the implementation of MIPPA regulations including model of care requirements, state contracts for Dual SNPs, comprehensive written statements of Medicaid benefits and protections, performance measurements for SNPs developed by CMS and the National Commission on Quality Assurance, a broad range of marketing rules including permissible provider-based activities, C-SNP validation rules, call center process issues, comprehensive written benefit statement requirements and related issues regarding structure of the summary of benefits, etc.; Worked to incorporate provisions from HR 2758 and S. 1307, "The Medicare Specialty Care Improvement and Protection Act of 2009," into various versions of House and Senate Health Care Reform legislation, including HR 3962, "Americas Affordable Health Choices Act of 2009, S.1796, Americas Healthy Future Act, HR 3590, "The Patient Protection and Affordable Care Act," and HR 4872, Health Care and Education Reconciliation Act Advocated on issues in the health care reform legislation related to SNP extension, improvement of risk adjusted payments for high risk, the structure of the quality bonus payments, establishment of an office on Medicare/Medicaid integration, changes in enrollment policies for SNPs, Dual SNP contracting provisions, the structure of MA benefits for SNPs, SNP certification programs, an exemption of Medicare and Medicaid premiums from the annual health insurance fee included in the Senate bill, the structure of the MA bidding system for SNPs, authority for CMS to include physician fee updates in MA payment rates retrospectively, assuming Congress acts of the sustainable growth rate issue before January 1, 2011, and related matters.

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

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

Public Law No: 111-148 (formerly HR3590): Patient Protection and Affordable Care Act H.R.4872: Health Care and Education Reconciliation Act of 2010 HR904, S547 Medicaid Prescription Drug Rebate Equalization Act of 2009: To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. HR2758, S1307 Medicare Specialty Care Improvement and Protection Act of 2009: 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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3962, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re this issue; HR 3590, An act entitled The Patient Protection and Affordable Care Act. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3590, An act entitled The Patient Protection and Affordable Care Act. Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income 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. Implementation of Medicare payment policies - HR 2718, 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 1380, 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. Medicare Advantage special needs plans - HR 2758, 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; S 1307, 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. Home and community-based services under Medicaid - HR 2688, 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. Part D enrollment - HR 3152, 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. Part D exceptions process, HR 3418, To amend part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs. Part B premiums - HR 3631, 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. Government-operated Part D plan, dual eligibles - S 1634, A bill to amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs. Guaranteed-isse MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. Medicaid FMAP - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes. Medicare physician payments - HR 3326, Making appropriations for the Department of Defense for the fiscal year ending September 30, 2010, and for other purposes; S 1776, 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. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform - S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

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

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

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

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

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

S. 1796 Americas Healthy Future Act (Baucus); H.R. 3962 Americas Affordable Health Choices Act (Dingell) Changes to Medicare Advantage/Special Needs plans under healthcare reform; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold); H.R.3590 The Patient Protection and Affordable Care Act (Reid managers amendment).

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

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

S. 1796 Americas Healthy Future Act (Baucus); H.R. 3962 Americas Affordable Health Choices Act (Dingell) Changes to Medicare Advantage/Special Needs plans under healthcare reform; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold); H.R.3590 The Patient Protection and Affordable Care Act (Reid managers amendment).

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

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

H.R. 684, Medicare Prescription Drug Savings and Choice Act (Berry) Part D reforms; H.R. 904, Medicaid Prescription Drug Rebate Equalization Act (Stupak) Medicaid drug costs; H.R. 1407, Medicare Part D Home and Community Services Copayment Equity Act (Doggett) Part D cost sharing; H.R. 1670, Community Choice Act (Davis) Medicaid coverage; H.R. 1832, Medicare Prescription Drug Affordability Act (Wexler) Part D reforms; H.R. 2501, Medicare Cost Contract Extension and Refinement Act (Pomeroy) Medicare cost plans; H.R. 2686, Medicare Advantage Payments (Israel) Medicare Advantage benchmark adjustments; H.R. 2688, Empowered at Home Act (Pallone) home and community-based services under Medicaid; H.R. 2700, Prescription Coverage Now Act (Doggett) low-income assistance under Medicare Part D; H.R. 2718, MedPAC Reform Act (Cooper) implementation of Medicare payment policies; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; H.R. 2847, Jobs for Main Street Act (Mollohan) Medicaid FMAP; H.R. 2860, Medicare Drug Savings Through Choice Act (Murphy) Part D reforms; H.R. 3152, Helping Seniors Choose their Medicare Drug Plan Act (Holt) Part D enrollment; H.R. 3200, Americas Affordable Health Choices Act (Dingell) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; H.R. 3326, Defense Appropriations Act (Murtha) Medicare physician payment; H.R. 3418, Medicare Prescription Drug Cost Equalization Act (Ellsworth) Part D exceptions process; H.R. 3590, Patient Protection and Affordable Care Act (Reid) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; H.R. 3631, Medicare Premium Fairness Act (Titus) Part B premiums; H.R. 3962, Americas Affordable Health Choices Act (Dingell) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; S. 75, Generics First Act (Kohl) Part D reforms; S. 266, Medicare Prescription Drug Gap Reduction Act (Nelson) Part D reforms; S. 330, Medicare Prescription Drug Savings and Choice Act (Durbin) Part D reforms; S. 534, Home and Community Services Copayment Equity Act (Nelson) Part D reforms; S. 547, Drug Rebate Equalization Act (Bingaman) Medicaid drug costs; S. 677, REPAIR Act (Ensign) means-testing Part D premiums; S. 683, Community Choice Act (Harkin) Medicaid coverage; S. 960, Medicare Early Access Act (Rockefeller) Medicare buy-in option; S. 1079, Medicare Cost Contract Extension and Refinement Act (Klobuchar) Medicare cost plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans; S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies; S. 1634, Medicare Prescription Drug Coverage Improvement Act (Rockefeller) government operated Part D plan, dual eligibles; S. 1669, Equal Access to Medicare Options Act (Kerry) guaranteed issue Medigap, Medicare Advantage enrollment; S. 1776, Medicare Physician Fairness Act (Stabenow) Medicare physician payment; S. 1796, Americas Healthy Future Act (Baucus) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, data, and audit issues, bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

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

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

Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3962, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re this issue; HR 3590, An act entitled The Patient Protection and Affordable Care Act. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3590, An act entitled The Patient Protection and Affordable Care Act. Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income 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. Implementation of Medicare payment policies - HR 2718, 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 1380, 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. Medicare Advantage special needs plans - HR 2758, 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; S 1307, 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. Home and community-based services under Medicaid - HR 2688, 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. Part D enrollment - HR 3152, 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. Part D exceptions process, HR 3418, To amend part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs. Part B premiums - HR 3631, 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. Government-operated Part D plan, dual eligibles - S 1634, A bill to amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs. Guaranteed-isse MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. Medicaid FMAP - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes. Medicare physician payments - HR 3326, Making appropriations for the Department of Defense for the fiscal year ending September 30, 2010, and for other purposes; S 1776, 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. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform - S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

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

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

Worked on behalf of SNP Alliance members on various regulatory issues related to the implementation of MIPPA regulations including model of care requirements, a broad range of marketing rules, state contracts for Dual SNPs, comprehensive written statements of Medicaid benefits and protections, performance measurements for SNPs developed by CMS and the National Commission on Quality Assurance, etc; Worked to incorporate provisions from HR 2758 and S. 1307, "The Medicare Specialty Care Improvement and Protection Act of 2009," into various versions of House and Senate Health Care Reform legislation, including: HR 3200 and HR 3962, two different versions of "Americas Affordable Health Choices Act of 2009;" S. 1796, "Americas Healthy Future Act of 2009;" and HR 3590, "The Patient Protection and Affordable Care Act." In particular, the Alliance focused on issues related to SNP extension, improvement of risk adjusted payments for high risk, the structure of the quality bonus payments, establishment of an office on Medicare/Medicaid integration, changes in HR 3200 enrollment policies for C-SNPs, Dual SNP contracting provisions, the structure of MA benefits for SNPs, SNP certification programs, an exemption of Medicare and Medicaid premiums from an annual health insurance fee or excise tax, the structure of the MA bidding system for SNPs and related matters.

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

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

H.R. 2758 - The Medicare Speciality Care Improvement and Protection Act of 2009- Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals S. 1307 - Medicare Special Needs Plans - Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals. H.R. 904 - Medicaid Prescription Drug Rebate Equalization Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. S. 547 - Medicaid Prescription Drug Rebate Equalization Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. H.R. 3200 - America's Affordable Health Choices Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. S. 1679 - The Affordable Health Choices Act - Medicaid Drug Rebate equalization for managed care organizations. Unnumbered Bill - America's Healthy Future Act 2009 - Medicaid Drug Rebate equalization for managed care organizations. H.R. 3962 - Affordable Health Care for America Act - health care reform legislation - Medicaid Drug Rebate equalization for managed care organizations. H.R. 3590 - The Patient Protectin and Affordable Care Act - heatlh care reform legislation - Medicaid Drug Rebate equalization for managed care organizations.

Client expense: $120,000 · Firm income: Not reported

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

HR 3200, S1679 Americas Affordable Health Choices Act of 2009: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and other purposes. H.R.3590:An act entitled The Patient Protection and Affordable Care Act. HR904, S547 Medicaid Prescription Drug Rebate Equalization Act of 2009: To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. HR2758, S1307 Medicare Specialty Care Improvement and Protection Act of 2009: 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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

- HR 904/S 547, "To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations", a/k/a "Medicaid Prescription Drug Rebate Equalization Act of 2009", regarding support for all provisions as they relate to extending the Medicaid prescription drug rebate to Medicaid MCO's. -HR 2758/ S 1307, "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", a/k/a, "Medicare Specialty Care Improvement and Protection Act of 2009" regarding all provisions with respect to a special needs plan extension. -HR 3200, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a, "America's Affordable Health Choices Act of 2009", regarding Medicaid provisions and Title VII with respect to extend Medicaid drug rebate to Medicaid MCO's, Extend SNP authority, Medicaid expansion for low-income populations, out of network amendment. - S 1679, "An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce", a/k/a, "Affordable Health Choices Act of 2009", regarding Medicaid provisions and Title I with respect to the expansion of Medicaid. - Support for "America's Healthy Future Act of 2009", (Bill number TBD), regarding the Medicaid provisions, Title I and Title II.

Client expense: $160,000 · Firm income: Not reported

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

Medicare Advantage program - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re this issue. Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income 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. Implementation of Medicare payment policies - HR 2718, 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 1380, 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. Medicare Advantage special needs plans - HR 2758, 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; S 1307, 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. Home and community-based services under Medicaid - HR 2688, 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. Part D enrollment - HR 3152, 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. Part D exceptions process, HR 3418, To amend part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs. Part B premiums - HR 3631, 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. Government-operated Part D plan, dual eligibles - S 1634, A bill to amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs. Guaranteed-isse MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Americas Healthy Future Act (Baucus) Medicare Advantage, Part D, special needs plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform; H.R. 684, Medicare Prescription Drug Savings and Choice Act (Berry) Part D reforms (cont.) H.R. 904, Medicaid Prescription Drug Rebate Equalization Act (Stupak) Medicaid drug costs; H.R. 1407, Medicare Part D Home and Community Services Copayment Equity Act (Doggett) Part D cost sharing; H.R. 1670, Community Choice Act (Davis) Medicaid coverage; H.R. 1832, Medicare Prescription Drug Affordability Act (Wexler) Part D reforms; H.R. 2501, Medicare Cost Contract Extension and Refinement Act (Pomeroy) Medicare cost plans; H.R. 2686, Medicare Advantage Payments (Israel) Medicare Advantage benchmark adjustments; H.R. 2688, Empowered at Home Act (Pallone) home and community-based services under Medicaid; H.R. 2700, Prescription Coverage Now Act (Doggett) low-income assistance under Medicare Part D; H.R. 2718, MedPAC Reform Act (Cooper) implementation of Medicare payment policies; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; H.R. 2860, Medicare Drug Savings Through Choice Act (Murphy) Part D reforms; H.R. 3152, Helping Seniors Choose their Medicare Drug Plan Act (Holt) Part D enrollment; H.R. 3200, Americas Affordable Health Choices Act (Dingell) Medicare Advantage, Part D, special needs plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; H.R. 3418, Medicare Prescription Drug Cost Equalization Act (Ellsworth) Part D exceptions process; H.R. 3631, Medicare Premium Fairness Act (Titus) Part B premiums; S. 75, Generics First Act (Kohl) Part D reforms; S. 266, Medicare Prescription Drug Gap Reduction Act (Nelson) Part D reforms; S. 330, Medicare Prescription Drug Savings and Choice Act (Durbin) Part D reforms; S. 534, Home and Community Services Copayment Equity Act (Nelson) Part D reforms; S. 547, Drug Rebate Equalization Act (Bingaman) Medicaid drug costs; S. 677, REPAIR Act (Ensign) means-testing Part D premiums; S. 683, Community Choice Act (Harkin) Medicaid coverage; S. 960, Medicare Early Access Act (Rockefeller) Medicare buy-in option; S. 1079, Medicare Cost Contract Extension and Refinement Act (Klobuchar) Medicare cost plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans;S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies; S. 1634, Medicare Prescription Drug Coverage Improvement Act (Rockefeller) government operated Part D plan, dual eligibles; S. 1669, Equal Access to Medicare Options Act (Kerry) guaranteed issue Medigap, Medicare Advantage enrollment MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including audit and encounter data issues), bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

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

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

Americas Healthy Future Act (Baucus)/HR 3200 Americas Affordable Health Choices Act (Dingell) Changes to Medicare Advantage/Special Needs plans under healthcare reform; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold)

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

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

Americas Healthy Future Act (Baucus)/HR 3200 Americas Affordable Health Choices Act (Dingell) Changes to Medicare Advantage/Special Needs plans under healthcare reform; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold)

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

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

H.R. 2758 - The Medicare Speciality Care Improvement and Protection Act of 2009- Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals S. 1307 - Medicare Special Needs Plans - Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals. H.R. 904 - Medicaid Prescription Drug Rebate Equalization Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. S. 547 - Medicaid Prescription Drug Rebate Equalization Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. H.R. 3200 - America's Affordable Health Choices Act of 2009 - Medicaid Drug Rebate equalization for managed care organizations. S. 1679 - The Affordable Health Choices Act - Medicaid Drug Rebate equalization for managed care organizations. Unnumbered Bill - America's Healthy Future Act 2009 - Medicaid Drug Rebate equalization for managed care organizations.

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

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

Worked on behalf of SNP Alliance members on various issues related to the implementation of MIPPA regulations including model of care requirements, marketing rules, state contracts for Dual SNPs, comprehensive written statements of Medicaid benefits and protections, etc; Worked to incorporate provisions from HR 2758, The Medicare Specialty Care Improvement and Protection Act of 2009, and the House TriCommittee Draft on Health Care Reform into HR 3200, Americas Affordable Health Choices Act of 2009, and with a special focus on issues related to SNP extension, improvement of risk adjusted payments for high risk, the structure of the quality bonus payments, establishment of an office on Medicare/Medicaid integration, changes in HR 3200 enrollment policies for C-SNPs, and related matters. Worked to include provisions from S. 1307, Medicare Specialty Care Improvement and Protection Act of 2009, into the Senate Finance Committee health care reform package. Special focus on issues related to SNP extension, improvement of risk adjusted payments for high risk, the structure of the quality bonus payments, establishment of an office on Medicare/Medicaid integration, structure for MA payment reform for dual eligible beneficiaries in chairmans mark and related matters.

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

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

- HR 904/ S 547, "To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations" a/k/a "Medicaid Prescription Drug Rebate Equalization Act of 2009", regarding support for all provisions as they relate to extending the Medicaid prescription drug rebate to Medicaid MCO's. HR 2758/ S 1307, "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", a/k/a, "Medicare Specialty Care Improvement and Protection Act of 2009" regarding all provisions with respect to a special needs plan extension. HR 3200, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a, "America's Affordable Health Choices Act of 2009", regarding Medicaid provisions and Title VII with respect to extend Medicaid drug rebate to Medicaid MCO's, Extend SNP authority, Medicaid expansion for low-income populations, out of network amendment. S 1679, "An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce", a/k/a, "Affordable Health Choices Act of 2009", regarding Medicaid provisions and Title I with respect to the expansion of Medicaid. Support for "America's Healthy Future Act of 2009", (Bill number TBD), regarding the Medicaid provisions, Title I and Title II.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3200, S1679 Americas Affordable Health Choices Act of 2009: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and other purposes. S___ Americas Healthy Future Act of 2009 HR904, S547 Medicaid Prescription Drug Rebate Equalization Act of 2009: To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. HR2758, S1307 Medicare Specialty Care Improvement and Protection Act of 2009: 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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

Worked on behalf of SNP Alliance members on various issues related to the implementation of MIPPA regulations; Advocated for changes to 2009 model of care reporting, reviewed and commented on revisions to 2010 SNP application and model of care format; The development and introduction of the Specialty Care Improvement and Protection Act of 2009, HR 2758 and S. 1307, respectively. This legislation would extend statutory authority for special needs plans (SNPs), require CMS to study and refine Medicare Advantage payment methods for high risk populations and advance the integration of Medicare and Medicaid through a CMS office on Medicare/Medicaid integration and the establishment of a special designation for fully integrated dual eligible SNPs. Worked to incorporate provisions from HR 2758 into the TriCommittee Health Care Reform Draft and HR 3200, Americas Affordable Health Choices Act of 2009, and to make certain modifications to the TriCommittee draft in areas such as the structure of the quality bonuses and structure of the MLR for SNPs and changes in enrollment policies for C-SNPs. Worked to include provisions in S. 1307, Medicare Specialty Care Improvement and Protection Act of 2009, as part of the Senate health care reform package. Special focus on incorporating S. 1307 provisions into the Senate Finance Committee Chairmans mark and to obtain support for refinements to MA risk adjustment, as defined by S. 1307. Worked with CMS to establish a specific structure for reporting and documenting MIPPA comprehensive written statement requirements as part of the standard summary of benefits and worked on draft dual eligible contract language consistent with MIPPA requirements for dual-SNPs to have draft contracts; Submitted comments on Medicare managed care rules regarding marketing;

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

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

- HR 2758, "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", a/k/a "Medicare Specialty Care Improvement and Protection Plan of 2009", regarding special needs plans extension. - S 1307, "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", a/k/a "Medicare Specialty Care Improvement and Protection Plan of 2009", regarding special needs plans extension. - HR 904, "To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations" a/k/a "Medicaid Prescription Drug Rebate Equalization Act of 2009", regarding support for all provisions. - S 547, "A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations" a/k/a "Drug Rebate Equalization Act of 2009", regarding support for all provisions. - Health Reform (bills not yet introduced), provisions regarding Medicaid, Children's Health Insurance Program, and Medicare.

Client expense: $145,000 · Firm income: Not reported

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

H.R. 2758- In support for the inclusion of all of the provisions of the Medicare Specialty Care Improvement and Protection Act of 2009 (the SNP Act) recently introduced by Representatives Kind and Baldwin in the House health reform legislation. In support for the inclusion of all of the provisions of S. 1307, the Medicare Specialty Care Improvement and Protection Act of 2009 (the SNP Act) recently introduced by Senators Feingold and Klobuchar, into the Senate health reform legislation

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Senate Finance Committee Draft Policy Options (Baucus-Grassley) Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medigap restrictions, Medicare FFS payment reform, Medicaid prescription drug rebates (cont.) House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medigap open enrollment; Medicaid prescription drug rebates; S.Con.Res. 13 Budget Resolution (Conrad) Medicare Advantage funding; H.R. 684, Medicare Prescription Drug Savings and Choice Act (Berry) Part D reforms; H.R. 904, Medicaid Prescription Drug Rebate Equalization Act (Stupak) Medicaid drug costs; H.R. 1407, Medicare Part D Home and Community Services Copayment Equity Act (Doggett) Part D cost sharing; H.R. 1670, Community Choice Act (Davis) Medicaid coverage; H.R. 1832, Medicare Prescription Drug Affordability Act (Wexler) Part D reforms; H.R. 2501, Medicare Cost Contract Extension and Refinement Act (Pomeroy) Medicare cost plans; H.R. 2686, Medicare Advantage Payments (Israel) Medicare Advantage benchmark adjustments; H.R. 2688, Empowered at Home Act (Pallone) home and community-based services under Medicaid; H.R. 2700, Prescription Coverage Now Act (Doggett) low-income assistance under Medicare Part D; H.R. 2718, MedPAC Reform Act (Cooper) implementation of Medicare payment policies; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; H.R. 2860, Medicare Drug Savings Through Choice Act (Murphy) Part D reforms; S. 75, Generics First Act (Kohl) Part D reforms; S. 266, Medicare Prescription Drug Gap Reduction Act (Nelson) Part D reforms; S. 330, Medicare Prescription Drug Savings and Choice Act (Durbin) Part D reforms; S. 534, Home and Community Services Copayment Equity Act (Nelson) Part D reforms; S. 547, Drug Rebate Equalization Act (Bingaman) Medicaid drug costs; S. 677, REPAIR Act (Ensign) means-testing Part D premiums; S. 683, Community Choice Act (Harkin) Medicaid coverage; S. 960, Medicare Early Access Act (Rockefeller) Medicare buy-in option; S. 1079, Medicare Cost Contract Extension and Refinement Act (Klobuchar) Medicare cost plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans; S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including audit and encounter data issues), bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

Client expense: $1,870,000 · Firm income: Not reported

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

Changes to Medicare Advantage program - Proposed legislation re this issue; the Administration's budget. Changes to Medicare Advantage program - potential legislation; Administration's budget outline. SCHIP - HR 2, To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. Medicare Advantage funding - SConRes 13, An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2010, revising the appropriate budgetary levels for fiscal year 2009, and setting forth the appropriate budgetary levels for fiscal years 2011 through 2014. Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. CHIP expansion - S 275, An original bill to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income 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. Implementation of Medicare payment policies - HR 2718, 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 1380, 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. Medicare Advantage special needs plans - HR 2758, 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; S 1307, 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. Home and community-based services under Medicaid - HR 2688, 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid Prescription Drug Rebate Equalization Act, H.R. 904/S. 547; Children's Health Insurance Program Reauthorization Act of 2009, H.R. 2; Medicare Specialty Care Improvement and Protection Act of 2009, H.R. 2758/S. 1307; America's Affordable Health Choices Act, H.R. 3200; Medicaid Managed Care Organization Provider Tax Extension; Medicaid Expansion and Funding; Medicaid Medical Loss Ratios; Actuarial Soundness in MCO Rate-Setting; Health Reform; Quality Initiatives; Fraud Prevention

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

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

Senate Finance Committee Draft Policy Options (Baucus-Grassley) - Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medicare FFS payment reform, Medicaid prescription drug rebates; House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) - Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medigap open enrollment; S.Con.Res. 13 Budget Resolution (Conrad) Medicare Advantage funding; H.Con.Res. 85 Budget Resolution (Spratt) health-related provisions; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans; S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies.

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

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

Senate Finance Committee Draft Policy Options (Baucus-Grassley) Medicare Advantage funding, special needs plans, Medicare FFS payment reform; S. 1307 Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage Special Need Plans; House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) Medicare Advantage funding, special needs plans; HR 2758 Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S.Con.Res. 13 Budget Resolution (Conrad) Medicare Advantage funding; H.Con.Res. 85 Budget Resolution (Spratt) health-related provisions.

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

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

Changes to Medicare Advantage/Special Need Plans under healthcare reform. S. 1307; HR 2758; HELP Committee Affordable Choices Act, Finance Committee Options Papers on Delivery System, Coverage and Financing and the House Tri-Committee Draft on Health Care Reform.

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

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

Senate Finance Committee Draft Policy Options (Baucus-Grassley) - Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medicare FFS payment reform, Medicaid prescription drug rebates; House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) - Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medigap open enrollment; S.Con.Res. 13 Budget Resolution (Conrad) Medicare Advantage funding; H.Con.Res. 85 Budget Resolution (Spratt) health-related provisions; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans; S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies.

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

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

CMS Advance Notice of Methodological Changes for FY2010; Senate Finance Committee Draft Policy Options (Baucus-Grassley) Medicare Advantage funding, special needs plans, Medicare FFS payment reform; S.1307 Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage Special Need Plans; House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) Medicare Advantage funding, special needs plans; HR 2758 Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S.Con.Res. 13 Budget Resolution (Conrad) Medicare Advantage funding; H.Con.Res. 85 Budget Resolution (Spratt) health-related provisions.

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

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

Senate Finance Committee Draft Policy Options (Baucus-Grassley) - Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medicare FFS payment reform, Medicaid prescription drug rebates; House Tri-Committee Discussion Draft for Health Reform (Waxman, Rangel, Miller) - Medicare Advantage funding, special needs plans, Medicaid eligibility expansion, Medigap open enrollment; S.Con.Res. 13 Budget Resolution (Conrad) Medicare Advantage funding; H.Con.Res. 85 Budget Resolution (Spratt) health-related provisions; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans; S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies.

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

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