Pre-existing Condition Patient Protection Act of 2009

S. 488/H.R. 716 - Access to Cancer Clinical Trials Act of 2009; H.R. 1189 - Colorectal Cancer Prevention, Early Detection, and Treatment Act of 2009; H.R. 1330 - Colorectal Cancer Screening and Detection Coverage Act of 2009; H.R. 756/S. 660 - National Pain Policy Act of 2009; S. 497/H.R. 2043 - Nurse Education, Expansion, and Development Act of 2009; Health Reform; Health Workforce Shortage Issues; S. 623/H.R. 1558 - Preexisting Condition Exclusion Patient Protection Act of 2009; (Continued) S. 643/H.R. 1619 - Children's Health Protection Act of 2009; S. 688/H.R. 1691 - Breast Cancer Patient Protection Act; H.R. 2366 - Cancer Drug Coverage Parity Act; FDA Regulation of Opioids; H.R. 2115- Men and Familes Health Care Act; Health Care Reform; H.R. 3962 - Affordable Health Care for America Act; H.R. 3590 - Patient Protection and Affordable Care Act; H.R. 4872 - Reconciliation Act of 2010.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

S. 515, H.R. 1260 Patent Reform Act of 2009 H.R. 1427, S. 726 Promoting Innovation and Access to Life-Saving Medicine Act H.R. 1548 Pathway for Biosimilars Act S. 623 Access to Life Saving Medicine Act S. 369, Preserve Access to Affordable Generics Act of 2009 H.R. 1706, Protecting Consumer Access to Generic Drugs Act of 2009

Client expense: $370,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

Health Insurance reform and Long Term Care issues HR 1, S. 1, S. 725, S. 703, S. 623, S. 207, S. 179, S. 82, S. 45, HR 1558, HR 1495, HR 1470, HR 1468, HR 1413, HR 1279, HR 1092, HR 676, HR 563, HR 542, HR 198, HR 194, HR 109, HR 15, HR 2, S. 702, S. 94, HR 1891, HR 897, HR 3200, HR 3590, HR 3501, HR 3502, HR 3962, HR 4872, H.R. 5853

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

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

HR 1583 (Mccarran-Ferguson). S. 819 (mandate autism coverage). HR 1253 (new plan disclosure rules). HR 1691/S. 688 (prohibit plan rescissions and establish minimum length of hospital stays for cancer patients) HR 1558/S. 623 (prohibit pre-existing condition exclusions; also HR 1619, S. 643, HR 1092) S. 442/ HR 1085 (to prohibit aggregate lifetime dollar limit) S> 697/HR 1721 (Long Term Care) H 975 (mammography mandate); HR 1339 (Mandate to cover deformities)

Client expense: $998,150 · Firm income: Not reported

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

S. 515, H.R. 1260 Patent Reform Act of 2009 H.R. 1427, S. 726 Promoting Innovation and Access to Life-Saving Medicine Act H.R. 1548 Pathway for Biosimilars Act S. 623 Access to Life Saving Medicine Act S. 369, Preserve Access to Affordable Generics Act of 2009 H.R. 1706, Protecting Consumer Access to Generic Drugs Act of 2009

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

H.R.3590, Patient Protection and Affordable Care Act - Lobbied in support of and on implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long-term services and supports. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.1569/H.R.3185, Medicare Graduate Nursing Education Act - Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population. S. 623/HR 1558, Pre-existing Condition Patient Protection Act of 2009 - Lobbied in support of bill that would prohibit insurers from denying health insurance or delaying coverage for people with pre-existing conditions. H.R. 2778, Health Equity and Accountability through Research Act of 2009 - Lobbied in support of bill that would address racial and ethnic disparities in care. S. 979/HR 2360, Small Business Health Options Programs Act - Lobbied in support of bill that would establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable and accessible. S.1213, Patient-Centered Outcomes Research Act - Lobbied in support of bill that would create a public-private partnership to conduct and disseminate comparative effectiveness research. S. 726/H.R. 1427, Promoting Innovation and Access to Life Saving Medicines - Discussed legislation which would create a pathway for approval of safe, effective biosimilar and generic biologic drugs. H.R. 3090, Health Equity and Accountability Act - Discussed need to end racial and ethnic disparities in care. S. 3686, Labor, HHS, Education and Related Agencies Appropriations Act FY 2011 - Lobbied for funding for healthcare services, research and training involving NIH, AHRQ, CMS, HRSA, HHS and AOA. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care law which makes improvements such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act and implementation of some provisions. H.R. 5364, Special Care Dentistry Act - Discussed bill that would require states to provide oral health coverage for aged, blind, or disabled individuals through a separate state adult dental program, with 100% federal match. H.R. 4213, American Workers, State and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR. H.R. 3081, Continuing Resolution, FY 2011 - Lobbied for funding for SSA, various health care, employment, aging services and nutrition programs. H.R. 5795, Personalize Your Care Act - Bill gives Americans the opportunity to make advance care plans should he or she become unable to direct their own care. S. 1177, Confidence in Long-Term Care Insurance Act - Bill provides options to help Americans pay for the long-term services and supports they may need, including to help them live in their homes and communities. H.R. 5890, Long-Term Care Insurance Reform Act - Bill provides options to help Americans pay for the long-term services and supports they may need, including to help them live in their homes and communities. S. 776, Promoting Small House Nursing Homes Act - Provides incentives for new, affordable models of long-term services and supports. H.R. 4224, Together We Care Act - Bill creates a three-year pilot program to train public housing residents to provide covered home-based health services. H.R. 5853, Fiscal Responsibility and Retirement Security Act - Bill requires review and approval by law prior to collection of premiums under the CLASS program, to require notice to individuals prior to enrollment, and to require termination of the program in the event of actuarial unsoundness, and for other purposes. S. 2814, Home Health Care Planning Improvement Act of 2010 - Bill recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. H.R. 4993, Home Health Care Planning Improvement Act of 2010 - Bill recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare.

Client expense: $4,710,000 · Firm income: Not reported

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

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

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

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

S. 488/H.R. 716 - Access to Cancer Clinical Trials Act of 2009; H.R. 1189 - Colorectal Cancer Prevention, Early Detection, and Treatment Act of 2009; H.R. 1330 - Colorectal Cancer Screening and Detection Coverage Act of 2009; H.R. 756/S. 660 - National Pain Policy Act of 2009; S. 497/H.R. 2043 - Nurse Education, Expansion, and Development Act of 2009; Health Reform; Health Workforce Shortage Issues; S. 623/H.R. 1558 - Preexisting Condition Exclusion Patient Protection Act of 2009; (Continued) S. 643/H.R. 1619 - Children's Health Protection Act of 2009; S. 688/H.R. 1691 - Breast Cancer Patient Protection Act; H.R. 2366 - Cancer Drug Coverage Parity Act; FDA Regulation of Opioids; H.R. 2115- Men and Familes Health Care Act; Health Care Reform; H.R. 3962 - Affordable Health Care for America Act; H.R. 3590 - Patient Protection and Affordable Care Act; H.R. 4872 - Reconciliation Act of 2010.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

Health Insurance reform and Long Term Care issues HR 1, S. 1, S. 725, S. 703, S. 623, S. 207, S. 179, S. 82, S. 45, HR 1558, HR 1495, HR 1470, HR 1468, HR 1413, HR 1279, HR 1092, HR 676, HR 563, HR 542, HR 198, HR 194, HR 109, HR 15, HR 2, S. 702, S. 94, HR 1891, HR 897, HR 3200, HR 3590, HR 3501, HR 3502, HR 3962, HR 4872, H.R. 5853

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

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

HR 1583 (Mccarran-Ferguson). S. 819 (mandate autism coverage). HR 1253 (new plan disclosure rules). HR 1691/S. 688 (prohibit plan rescissions and establish minimum length of hospital stays for cancer patients) HR 1558/S. 623 (prohibit pre-existing condition exclusions; also HR 1619, S. 643, HR 1092) S. 442/ HR 1085 (to prohibit aggregate lifetime dollar limit) S> 697/HR 1721 (Long Term Care) H 975 (mammography mandate); HR 1339 (Mandate to cover deformities)

Client expense: $638,299 · Firm income: Not reported

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

HR 1558 & S 623: Pre-existing Condition Patient Protection Act HR 1708 & S 700: Ending the Medicare Disability Waiting Period Act of 2009 HR 1085 & S 442: Health Insurance Coverage Protection Act HR 2408 & S 1545: Scleroderma Research and Awareness Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 515, H.R. 1260 Patent Reform Act of 2009 H.R. 1427, S. 726 Promoting Innovation and Access to Life-Saving Medicine Act H.R. 1548 Pathway for Biosimilars Act S. 623 Access to Life Saving Medicine Act S. 369, Preserve Access to Affordable Generics Act of 2009 H.R. 1706, Protecting Consumer Access to Generic Drugs Act of 2009

Client expense: $570,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

S. 515, H.R. 1260 Patent Reform Act of 2009 H.R. 1427, S. 726 Promoting Innovation and Access to Life-Saving Medicine Act H.R. 1548 Pathway for Biosimilars Act S. 623 Access to Life Saving Medicine Act S. 369, Preserve Access to Affordable Generics Act of 2009 H.R. 1706, Protecting Consumer Access to Generic Drugs Act of 2009

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Affordable Health Care for America Act (H.R. 3962) Affordable Health Choices Act (draft) Affordable Health Choices Act (S. 1679) America's Affordable Health Choices Act (H.R. 3200) America's Healthy Future Act (Senate Finance - unnumbered) Children's Health Insurance Program Reauthorization Act (S. 275/H.R. 2) Children's Health Protection Act (S. 643/H.R. 1619) Congenital Heart Futures Act (S. 621/H.R. 1570) Health Care and Education Reconciliation Act (H.R. 4872) Health Equity and Accountability Act (H.R. 3090) Health Insurance Coverage Protection Act (S. 442/H.R. 1085) Heart Disease Education, Analysis and Research, and Treatment for Women Act (HEART for Women Act) (S.422/H.R. 1032) Informed Consumer Choices in Health Care Act (S. 1050/H.R. 2427) Josh Miller HEARTS Act (S. 1197/H.R. 1380) National Atrial Fibrillation Awareness Month Resolution (H.Res.255) NIH-FDA Joint Leadership Council (FDA-2010-N-0233) Patient Protection and Affordable Care Act (H.R. 3590) Preexisting Condition Exclusion Patient Protection Act (S. 623/H.R. 1558) Tri-Committee Health Care Reform Bill (House draft) Women's Health Insurance Fairness Act (S.969) Workplace Wellness Grants (H.R. 3962/H.R. 3590) Young Adult Healthcare Coverage Act of 2009 (H.R. 2831)

Client expense: $105,016 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE

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

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

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

Lobbying on scope of Physician Payments Sunshine Act (S. 301); general Medicare and Medicade reform issues (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S. 1679); electronic prescribing issues (no specific legislation); anti-counterfeiting legislation concerning drugs/pedigree drug legislation; legislation on drug and device safety (Food and Drug Administration Globalization Act of 2009 H.R. 759); generic drug legislation (H.R. 573); follow-on biologics (Pre-existing Condition Patient Protection Act of 2009 S. 623); Medicare Prescription Drug Savings and Choice Act of 2009 (S. 330 & H.R. 684); drug disposal legislation (Secure and Responsible Drug Disposal Act of 2009 H.R. 1359 and Safe Drug Disposal Act of 2009 H.R. 1191, S. 1292, S. 1336); federal preemption issues in Medical Device Safety Act of 2009 (S. 540 and H.R. 1346); National Pain Care Policy Act of 2009 (H.R. 756 & S. 660); drug reimportation issues (Pharmaceutical Market Access and Drug Safety Act of 2009, S. 525 & H.R. 1298); disposal of drugs (H.R. 1191, H.R. 1359, S. 1292 & S. 1336); biosimilar drugs (H.R. 1427, H.R. 1548, S. 726); tax on pharmaceutical companies (H.R. 3590, S. 1796); health care reform (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S. 1679, America's Healthy Future Act S. 1796, H.R. 3590, H.R. 3962, H.R. 3200, H.R. 4872); modify approval of oxycodone (H.R. 4956); reauthorization of Prescription Drug User Fee Act; health care technical corrections (H.R. 5712); life sciences research tax credit legislation.

Client expense: $360,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, SENATE

Access to Care; Health Care Reform; Out of Pocket Expenses; Life Time Caps; S. 623/H.R. 1558 - Pre-existing Condition Patient Protection Act of 2009 S. 643/H.R. 1619 - Children's Health Protection Act of 2009 Psoriasis Patient Registry

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, White House Office

S. 515 - Patent Reform Act; S. 623/H.R. 1558 - Preexisting Conditon Exclusion Patient Protection Act of 2009; S. 643/H.R. 1619 - Children's Health Protection Act of 2009; Women with Disabilities Access to Health Care; Health Care Reform; H.R. 1938 - Promoting Wellness for Individuals with Disabilities Act of 2009; Prosthetics and Orthotics Parity Act; Access to Care for Individuals with Disabilities; H.R.. 5462/S.3479 - Birth Defect Prevention Risk Reduction and Awareness Act; Orthotic and Parity Bill.

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

S. 488/H.R. 716 - Access to Cancer Clinical Trials Act of 2009; H.R. 1189 - Colorectal Cancer Prevention, Early Detection, and Treatment Act of 2009; H.R. 1330 - Colorectal Cancer Screening and Detection Coverage Act of 2009; H.R. 756/S. 660 - National Pain Policy Act of 2009; S. 497/H.R. 2043 - Nurse Education, Expansion, and Development Act of 2009; Health Reform; Health Workforce Shortage Issues; S. 623/H.R. 1558 - Preexisting Condition Exclusion Patient Protection Act of 2009; (Continued) S. 643/H.R. 1619 - Children's Health Protection Act of 2009; S. 688/H.R. 1691 - Breast Cancer Patient Protection Act; H.R. 2366 - Cancer Drug Coverage Parity Act; FDA Regulation of Opioids; H.R. 2115- Men and Familes Health Care Act; Health Care Reform; H.R. 3962 - Affordable Health Care for America Act; H.R. 3590 - Patient Protection and Affordable Care Act; H.R. 4872 - Reconciliation Act of 2010.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

H.R.3590, Patient Protection and Affordable Care Act - Lobbied in support of and on implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long-term services and supports. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.1569/H.R.3185, Medicare Graduate Nursing Education Act - Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population. (no bill) S. 623/HR 1558, Pre-existing Condition Patient Protection Act of 2009 - Lobbied in support of bill that would prohibit insurers from denying health insurance or delaying coverage for people with pre-existing conditions. H.R. 2778, Health Equity and Accountability through Research Act of 2009 - Lobbied in support of bill that would address racial and ethnic disparities in care. S. 979/HR 2360, Small Business Health Options Programs Act - Lobbied in support of bill that would establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable and accessible. S.1213, Patient-Centered Outcomes Research Act - Lobbied in support of bill that would create a public-private partnership to conduct and disseminate comparative effectiveness research. S. 726/H.R. 1427, Promoting Innovation and Access to Life Saving Medicines - Discussed legislation which would create a pathway for approval of safe, effective biosimilar and generic biologic drugs. H.R. 3090, Health Equity and Accountability Act - Discussed need to end racial and ethnic disparities in care. Labor, HHS, Education and Related Agencies Appropriations Act FY 2011 - Lobbied for funding for healthcare services, research and training involving NIH, AHRQ, CMS, HRSA, HHS and AOA. (no bill) H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care law which makes improvements such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act and implementation of some provisions. Provided comment letter to HHS on their draft Strategic Framework on Multiple Chronic Conditions. (no bill number) H.R. 5364, Special Care Dentistry Act - Discussed bill that would require states to provide oral health coverage for aged, blind, or disabled individuals through a separate state adult dental program, with 100% federal match. H.R. 4213, American Workers, State and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR.

Client expense: $4,250,000 · Firm income: Not reported

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

H.R.3590, Patient Protection and Affordable Care Act - Lobbied in support of and on implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long-term services and supports. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.1569/H.R.3185, Medicare Graduate Nursing Education Act - Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population. (no bill) S. 623/HR 1558, Pre-existing Condition Patient Protection Act of 2009 - Lobbied in support of bill that would prohibit insurers from denying health insurance or delaying coverage for people with pre-existing conditions. H.R. 2778, Health Equity and Accountability through Research Act of 2009 - Lobbied in support of bill that would address racial and ethnic disparities in care. S. 979/HR 2360, Small Business Health Options Programs Act - Lobbied in support of bill that would establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable and accessible. S.1213, Patient-Centered Outcomes Research Act - Lobbied in support of bill that would create a public-private partnership to conduct and disseminate comparative effectiveness research. S. 726/H.R. 1427, Promoting Innovation and Access to Life Saving Medicines - Discussed legislation which would create a pathway for approval of safe, effective biosimilar and generic biologic drugs. H.R. 3090, Health Equity and Accountability Act - Discussed need to end racial and ethnic disparities in care. Labor, HHS, Education and Related Agencies Appropriations Act FY 2011 - Lobbied for funding for healthcare services, research and training involving NIH, AHRQ, CMS, HRSA, HHS and AOA. (no bill) H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care law which makes improvements such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act and implementation of some provisions. Provided comment letter to HHS on their draft Strategic Framework on Multiple Chronic Conditions. (no bill number) H.R. 5364, Special Care Dentistry Act - Discussed bill that would require states to provide oral health coverage for aged, blind, or disabled individuals through a separate state adult dental program, with 100% federal match. H.R. 4213, American Workers, State and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR.

Client expense: $4,250,000 · Firm income: Not reported

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

HR 1583 (Mccarran-Ferguson). S. 819 (mandate autism coverage). HR 1253 (new plan disclosure rules). HR 1691/S. 688 (prohibit plan rescissions and establish minimum length of hospital stays for cancer patients) HR 1558/S. 623 (prohibit pre-existing condition exclusions; also HR 1619, S. 643, HR 1092) S. 442/ HR 1085 (to prohibit aggregate lifetime dollar limit) S> 697/HR 1721 (Long Term Care) H 975 (mammography mandate); HR 1339 (Mandate to cover deformities)

Client expense: $1,568,045 · Firm income: Not reported

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

Affordable Health Care for America Act (H.R. 3962) Affordable Health Choices Act (draft) Affordable Health Choices Act (S. 1679) America's Affordable Health Choices Act (H.R. 3200) America's Healthy Future Act (Senate Finance - unnumbered) Childhood Obesity Task Force Children's Health Insurance Program Reauthorization Act (S. 275/H.R. 2) Children's Health Protection Act (S. 643/H.R. 1619) Congenital Heart Futures Act (S. 621/H.R. 1570) Health Care and Education Reconciliation Act (H.R. 4872) Health Equity and Accountability Act (H.R. 3090) Health Insurance Coverage Protection Act (S. 442/H.R. 1085) Heart Disease Education, Analysis and Research, and Treatment for Women Act (HEART for Women Act) (S.422/H.R. 1032) Informed Consumer Choices in Health Care Act (S. 1050/H.R. 2427) Josh Miller HEARTS Act (S. 1197/H.R. 1380) National Atrial Fibrillation Awareness Month Resolution (H.Res.255) Patient Protection and Affordable Care Act (H.R. 3590) Preexisting Condition Exclusion Patient Protection Act (S. 623/H.R. 1558) Resolution Designating May 1 through May 7, 2009 as National Physical Education and Sports Week (S.RES.133/H.RES.503) Tri-Committee Health Care Reform Bill (House draft) Women's Health Insurance Fairness Act (S.969) Workplace Wellness Grants (H.R. 3962/H.R. 3590) Young Adult Healthcare Coverage Act of 2009 (H.R. 2831)

Client expense: $135,901 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)

Health Insurance reform and Long Term Care issues HR 1, S. 1, S. 725, S. 703, S. 623, S. 207, S. 179, S. 82, S. 45, HR 1558, HR 1495, HR 1470, HR 1468, HR 1413, HR 1279, HR 1092, HR 676, HR 563, HR 542, HR 198, HR 194, HR 109, HR 15, HR 2, S. 702, S. 94, HR 1891, HR 897, HR 3200, HR 3590, HR 3962, HR 4872

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

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

HR 1558 & S 623: Pre-existing Condition Patient Protection Act HR 1708 & S 700: Ending the Medicare Disability Waiting Period Act of 2009 HR 1085 & S 442: Health Insurance Coverage Protection Act HR 2408 & S 1545: Scleroderma Research and Awareness Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 716, Access to Cancer Clinical Trials Act (Israel) clinical trials coverage mandate; H.R. 850, Small Business CHOICE Act (Velazquez) small employer health options; H.R. 859, Small Business CHOICE Act (Velazquez) small employer health options; (cont.) INS (Legislative) H.R. 1085, Health Insurance Coverage Protection Act (Eshoo) lifetime benefit limits; H.R. 1092, No Discrimination in Health Insurance Act (Kagen) preexisting condition exclusions, affiliation periods, uniform premiums; H.R. 1253, Health Insurance Restrictions and Limitations Clarification Act (Burgess) disclosure of coverage exclusions; H.R. 1321, Healthy Americans Act (Eshoo) comprehensive health reform; H.R. 1558, Preexisting Condition Patient Protection Act (Courtney) preexisting condition exclusions; H.R. 1583, Insurance Industry Competition Act (DeFazio) McCarran Ferguson reforms; H.R. 1619, Children's Health Protection Act (Schwartz) preexisting condition exclusions for children; H.R. 1691, Breast Cancer Patient Protection Act (DeLauro) rescissions, hospital stays for breast cancer patients; H.R. 1721, CLASS Act (Pallone) national LTC program; H.R. 1880, National Insurance Consumer Protection Act (Bean) regulatory reform; H.R. 2360, SHOP Act (Kind) small employer health options; H.R. 2402, Woman's Health Insurance Fairness Act (Neal) gender rating for health insurance; H.R. 2413, Autism Treatment Acceleration Act (Doyle) coverage for autism spectrum disorders; H.R. 2427, Informed Consumer Choices in Health Care Act (DeLauro) federal standards for health insurance, consumer information; H.R. 2457, Right to a Second Medical Opinion Act (Davis) coverage of second opinions; H.R. 2609, Insurance Information Act (Kanjorski) Federal Office of Insurance Information; H.R. 2635, Gender Equity in Health Premiums Act (Sanchez) gender rating for health insurance; H.R. 2833, Medical Loss Ratios (Ellison) medical loss ratios; H.R. 2940, Women's Obstetrician and Gynecologist Medical Access Now Act (Davis) direct access to ob/gyns; H.R. 3200, Americas Affordable Health Choices Act (Dingell) government-run health plan, health insurance exchange, regulatory reform, health choices commissioner, insurance market reforms, individual coverage requirement, benefit packages, CLASS Act, medical loss ratios, premium assistance; H.R. 3217, Health Care Choice Act (Shadegg) national marketplace; H.R. 3584, Health Care Consumer Protection Act (Forbes) reinstatement of coverage upon payment of overdue premiums; H.R. 3590, Patient Protection and Affordable Care Act (Reid) government-run health plan, health insurance cooperatives, multi-state plans, insurance market reforms, health insurance exchanges, benefit packages, medical loss ratios, CLASS Act, regulatory reform, individual coverage requirement, premium assistance, federal rate review process, health care choice compacts, appeals procedures, disclosure requirements, high risk pool program, McCarran-Ferguson Act; H.R. 3596, Health Insurance Industry Antitrust Enforcement Act (Conyers) changes to McCarran-Ferguson Act; H.R.3681, Fairness in Health Insurance Act (Ellison) medical loss ratios; H.R. 3962, Americas Affordable Health Choices Act (Dingell) government-run health plan, health insurance exchange, regulatory reform, health choices commissioner, insurance market reforms, individual coverage requirement, benefit packages, CLASS Act, medical loss ratios, premium assistance, federal rate review process, health care choice compacts, high risk pool program, McCarran-Ferguson Act; H.R. 4078, Long-Term Care Insurance Disclosure Act (Perriello) model disclosure form for long-term care insurance; H.R. 4563, Cancer Screening Coverage Act (Maloney) coverage requirement for cancer screening; H.R. 4626, Health Insurance Industry Fair Competition Act (Perriello) McCarran-Ferguson antitrust exemption; H.R. 4757, Health Insurance Rate Authority Act (Schakowsky) federal rate review process; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to individual coverage requirement, grandfathered plans, immediate insurance reforms, premium assistance, CLASS Act, coverage issues, quality improvements, delivery system reforms; S. 79, Healthy Businesses, Healthy Workers Reinsurance Act (Kerry) reinsurance; S. 93, Small Business Empowerment Act (Brown) small employer health options; S. 391, Healthy Americans Act (Wyden) comprehensive health reform; S. 442, Health Insurance Coverage Protection Act (Dorgan) lifetime benefit limits; S. 488, Access to Cancer Clinical Trials Act (Brown) clinical trials coverage mandate; S. 623, Pre-existing Condition Patient Protection Act (Rockefeller) preexisting condition exclusions; S. 643, Children's Health Protection Act (Lautenberg) preexisting condition exclusions for children; S. 688, Breast Cancer Patient Protection Act (Snowe) rescissions, hospital stays for breast cancer patients; S. 697, CLASS Act (Kennedy) national LTC program; S. 819, Autism Treatment Acceleration Act (Durbin) coverage for autism spectrum disorders; S. 969, Women's Health Insurance Fairness Act (Kerry) gender rating for health insurance; S. 979, SHOP Act (Durbin) small employer health options; S. 1050, Informed Consumer Choices in Health Care Act (Rockefeller) federal standards for health insurance, consumer information; S. 1149, Annual and Lifetime Health Care Limit Elimination Act (Rockefeller) annual and lifetime coverage limits; S. 1177, Confidence in Long-Term Care Insurance Act (Kohl) LTC consumer protections; (cont.) INS (Legislative) S. 1459, Health Care Choice Act (DeMint) national marketplace; S. 1626, Long Term Care Insurance Integrity Act (Klobuchar) third party review of LTCI disputed claims; S. 1636, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms for LTC insurance; S. 1679, Affordable Health Choices Act (Harkin) government-run health plan, insurance market reforms, health benefit gateways, benefit packages, medical loss ratios, CLASS Act, regulatory reform, individual coverage requirement, premium assistance; S. 1681, Health Insurance Industry Antitrust Enforcement Act (Leahy) changes to McCarran-Ferguson Act; S. 1730, Fairness in Health Insurance Act (Franken) medical loss ratios; S. 1796, Americas Healthy Future Act (Baucus) government-run health plan, health insurance cooperatives, health insurance exchange, insurance market reforms, individual coverage requirement, benefit packages, premium assistance, medical loss ratios, regulatory reform; S. 3078, Health Insurance Rate Authority Act (Feinstein) federal rate review process INS (Regulatory) Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials; implementation of the Mental Health Parity Act requirements; issues related to COBRA subsidy requirements, and issues related to genetic nondiscrimination.

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

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

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

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

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

HR.463,The Prevention First Act; Comprehensive Sexuality Education funding (general); H.R. 1691/S.688, Breast Cancer Patient Protection Act. H.R.20/S.324, Melanie Blocker Stokes MOTHERS Act; H.R. 2427/S. 1050, Informed Consumer Choices in Health Care Act; America's Healthy Future Act; National HIV/AIDS Strategy (general); H.R. 3312 Preventing Unintended Pregnancies, Reducing the Need for Abortion and Supporting Parents; H.R. 1558/S. 623, Pre-existing Condition Patient Protection Act.; Cord Blood Banking (general); S.670, Smoke Free Mothers and Babies Act of 2009; H.R. 3090, Health Equity and Accountability Act; H.R. 2635, Gender Equity in Health Premiums Act; S. 969, H.R. 2402 Women's Health Insurance Fairness Act; H.R. 3200, America's Affordable Health Choices Act; Stillbirth (general); Sudden unexpected infant deaths (general); Healthcare reform (general); Postpartum Depression (general); Emergency Contraception over the counter;Insurance Transparency (general); Pre-existing condition exclusion (general); Gender rating (general); Maternity Coverage (general); S. 1303 Medical Home Demonstration Project; Alternatives to Medical Liability Reform Demonstration Project (general); Young Adult Plans (general); Preventive Care (general); Advanced Diagnostic Imaging (general); Domestic Violence(general); Prescription Drug Coverage (general); Comparative Effectiveness Research (general); S. 1796 America's Healthy Future Act; S.1679 Affordable Health Choices Act; Medicaid SCHIP Coverage and Reimbursement; HIV Screening (general); H.R. 3962 Affordable Health Care For America Act; H.R. 2941Gynecological Cancer; H.R. 3590 Patient Protection and Affordable Care Act of 2009; Breastfeeding; Medical Liability Reform (general); HR 4386, S. 2904 Emergency Contraception in the Military; Direct Access to Ob-Gyns (general); S. 1742, H.R. 4235 Women's Hospitals Education Equity; United States Preventive Services Task Force Mammography Recommendations; National HIV/AIDS Strategy Steps; H.R. 3854 Small Business Financing and Investment Act of 2009; H.R. 4216 Personal Health Record Act of 2009; Abortion Restrictions; H.R. 3590 Patient Protection and Affordable Care Act; H.R. 4872 Health Care and Reconciliation Act of 2010; Health IT (general); H.R. 4985 Medicare Decisions and Accountability Act of 2010.

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE

S. 515, H.R. 1260 Patent Reform Act of 2009 H.R. 1427, S. 726 Promoting Innovation and Access to Life-Saving Medicine Act H.R. 1548 Pathway for Biosimilars Act S. 623 Access to Life Saving Medicine Act S. 369, Preserve Access to Affordable Generics Act of 2009 H.R. 1706, Protecting Consumer Access to Generic Drugs Act of 2009

Client expense: $390,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

HR 525 & S 406 - Association Health Plans. NAIFA opposes exempting AHP's from state benefit, regulatory oversight and solvency laws. S. 1995 allows AHP's to offer only issued plans that are subject to state solvency standards. Some regulatory oversight and an "average" of state mandated coverages. S. 725, HR 1470 - would amend IRC of 1986 to allow self emloyed individuals to deduct health insurance costs in computing self-employment taxes. NAIFA supports. HR 3590 - Provides health care for most americans, controls costs and enhances health care system quality. NAIFA remains concerned that this proposal will increase costs to families and businesses. HR 1558, S. 623, HR 1092 - Amends title I of ERISA, title XXVII of the Public Service Act & IRC of 1986 to prohibit preexisting condition exclusions in group health plans and in health coverage in the group and individual markets. NAIFA opposes. S 207 - Amend the IRC of 1986 to allow deduction for health insurance premiums. NAIFA supports. HR 176 & HR 1177 - would allow unused flexible spending arrangement funds to be carried over to the next year. NAIFA & AHIA favors this option. HR 27 - An "Above the line" deduction for "higher deductible" health plans coupled with HSA's. NAIFA supports. S.4 the Health American Act. NAIFA supports many provisions but concerned over the bills support for AHPs. HR 37, S. 978, HR 1872, HR 2063, HR 3873 creates Health Savings Accounts. NAIFA supports. HR 3511, S. 1569. NAIFA supports allowing states to establish LTC partnerships. HR 6331 - Would cut funding for Medicare Advantage - NAIFA opposes. HR 2096 & S. 702 - The Long-Term Care Affordability and Security Act of 2009 expands the authority under IRC Sectioin 125 that allows individuals to pay for certain benefits offered through cafeteria plans and/or flexible spending arrangement s with pre-tax dollars. AHIA & NAIFA support. HR 897 - Allows for Long Term Care insurance to be offered through cafeteria plans and/or FSA's as well as creates an above the line deduction for LTC premiums and provides a tax credit for caregivers. NAIFA & AHIA support. S. 93 - A bill to provide quality affordable health insurance for small employers and individuals. S.82 - A bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, to limit income eligibility expansions under that program until the lowest income eligible individuals are enrolled, and for other purposes. NAIFA supports. S. 45 - A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. NAIFA supports. HR 1468 - To provide health care liability reform, and for other purposes. NAIFA supports. HR 1413 - To amend the Internal Revenue Code of 1986 to allow certain public employees a deductioin for distributions from governmental plans for health and long-term care insurance,and for other purposes. NAIFA supports. HR 1279 - To amend the Internal Revenue Code of 1986 to increase the contribution limits to dependent care flexible spending accounts and to provide for a carryover of unused dependent care benefits. NAIFA supports. S. 1177 - Confidence in Long Term Care Insurance Act would instruct the Health and Human Services Department to ask the NAIC to collect data and also create a website called "LTC Insurance Compare" to help consumers research long term care insurance. NAIFA supports. HR 563 - To amend title XXI of the Social Security Act to require States to provide priority under the State Children's Health Insurance Program (SCHIP) to children in families with gross income below 200 percent of the Federal poverty level. NAIFA supports. HR 542 - To amend titles XIX and XXI of the Social Security Act to permit States to rely on findings from an express plan agency to conduct simplified eligibility determinations under Medicaid and the State Children's Health Insurance Program. NAIFA supports. HR 198 - To amend the Internal Revenue Code of 1986 to allow a deduction for amounts paid for health insurance and prescription drug costs of individuals. NAIFA supports. HR 194 - To amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009, and for other purposes. NAIFA opposes. HR 109 - To provide for the offering of Health Benefit Plans to individuals, to increase funding for State high risk health insurance pools, and to promote best practice protocols for State high risk pools. NAIFA supports. HR 15 - To provide a program of national health insurance, and for other purposes. NAIFA opposes. 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. NAIFA opposes. S 94 - A bill to amend the Internal Revenue Code of 1986 to provide for a nonrefundable tax credit for long-term care insurance premiums. NAIFA supports. HR 1891 - To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual's long-term care insruance premiums. NAIFA supports. HR 897 - To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs. NAIFA supports. HR 3590, HR 4872 - To enact the "Patient Protection and Affordable Care Act." NAIFA opposes certain provisions.

Client expense: $315,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

Lobbying on scope of Physician Payments Sunshine Act (S. 301); general Medicare and Medicade reform issues (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S 1679); electronic prescribing issues (no specific legislation); anti-counterfeiting legislation concerning drugs/pedigree drug legislation; legislation on drug and device safety (Food and Drug Administration Globalization Act of 2009 H.R. 759); generic drug legislation (H.R. 573); follow-on biologics (Pre-existing Condition Patient Protection Act of 2009 S. 623); Medicare Prescription Drug Savings and Choice Act of 2009 (S. 330 & H.R. 684); drug disposal legislation (Secure and Responsible Drug Disposal Act of 2009 H.R. 1359 and Safe Drug Disposal Act of 2009 H.R. 1191, S. 1292, S. 1336); federal preemption issues in Medical Device Safety Act of 2009 (S. 540 and H.R. 1346); National Pain Care Policy Act of 2009 (H.R. 756 & S. 660); drug reimportation issues (Pharmaceutical Market Access and Drug Safety Act of 2009, S. 525 & H.R. 1298); disposal of drugs (H.R. 1191, H.R. 1359, S. 1292, & S. 1336); biosimilar drugs (H.R. 1427, H.R. 1548, S. 726); tax on pharmaceutical companies (H.R. 3590, S. 1796); health care reform (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S. 1679, America's Healthy Future Act S. 1796, H.R. 3590, H.R. 3962, H.R. 3200, H.R. 4872); modify approval of oxycodone (H.R. 4956); reauthorization of Prescription Drug User Fee Act.

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

Government targets: Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, SENATE

Health Insurance reform and Long Term Care issues HR 1, S. 1, S. 725, S. 703, S. 623, S. 207, S. 179, S. 82, S. 45, HR 1558, HR 1495, HR 1470, HR 1468, HR 1413, HR 1279, HR 1092, HR 676, HR 563, HR 542, HR 198, HR 194, HR 109, HR 15, HR 2, S. 702, S. 94, HR 1891, HR 897, HR 3200, HR 3590, HR 3962, HR 4872

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

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

S. 301 Physician Payment Sunshine Act, S. 537 Sunshine in Litigation Act, S. 623 The Pre-existing Condition Patient Protection Act, H.R. 427 Promoting Innovation and Access to Life-Saving Medicine Act, H.R. 1548 Pathway for Biosimilars Act, S. 726 Licensing of Biosimilar/Biogeneric Products, general comparative effectiveness issues, general health reform and the un/underinsured, general diabetes legislation, HR 4872 Health Care Reconcilation Act of 2010, HR 3590 Patient Protection and Affordable Care Act S 1679 Affordable Health Choices Act; HR 3961Medicare Physician Payment Reform Act of 2009; S 1796 America's Healthy Future Act of 2009; HR 3962 Affordable Health Care for America Act; HR 3590 Senate Leadership's Health Care Overhaul; H.R. 1995 Eliminating Disparities in Diabetes Prevention Access and Care Act of 2009, FTC Report "Emerging Health Care Issues: Follow-on Bilogic Drug Competition," mental health parity, value based insurance design, quality of care, adhereance.

Client expense: $421,094 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

S. 515 - Patent Reform Act; S. 623/H.R. 1558 - Preexisting Conditon Exclusion Patient Protection Act of 2009; S. 643/H.R. 1619 - Children's Health Protection Act of 2009; Women with Disabilities Access to Health Care; Health Care Reform; H.R. 1938 - Promoting Wellness for Individuals with Disabilities Act of 2009; Prosthetics and Orthotics Parity Act

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

S. 488/H.R. 716 - Access to Cancer Clinical Trials Act of 2009; H.R. 1189 - Colorectal Cancer Prevention, Early Protection, and Treatment Act of 2009; H.R. 1330 - Colorectal Cancer Screening and Detection Coverage Act of 2009; H.R. 756/S. 660 - National Pain Policy Act of 2009; S. 497/H.R. 2043 - Nurse Education, Expansion, and Development Act of 2009; Health Reform; Health Workforce Shortage Issues; S. 623/H.R. 1558 - Preexisting Condition Exclusion Patient Protection Act of 2009; (Continued) S. 643/H.R. 1619 - Children's Health Protection Act of 2009; S. 688/H.R. 1691 - Breast Cancer Patient Protection Act; H.R. 2366 - Cancer Drug Coverage Parity Act; FDA Regulation of Opioids; H.R. 2115- Men and Familes Health Care Act; Health Care Reform; H.R. 3962 - Affordable Health Care for America Act; H.R. 3590 - Patient Protection and Affordable Care Act; H.R. 4872 - Reconciliation Act of 2010.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

Access to Care; Health Care Reform; Out of Pocket Expenses; Life Time Caps; S. 623/H.R. 1558 - Pre-existing Condition Patient Protection Act of 2009 S. 643/H.R. 1619 - Children's Health Protection Act of 2009 Psoriasis Patient Registry

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, White House Office

H.R.3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long-term services and supports. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Discussed the need for bipartisan action on health care reform legislation, such as affordable and accessible quality healthcare with a focus on the 50-64 year old population. (no bill) Discussed healthcare reform and issues around the public plan option (no bill). S.1569/H.R.3185 Medicare Graduate Nursing Education Act - Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population. (no bill) S. 623/HR 1558, Pre-existing Condition Patient Protection Act of 2009 - Lobbied in support of bill that would prohibit insurers from denying health insurance or delaying coverage for people with pre-existing conditions. H.R. 2778, Health Equity and Accountability through Research Act of 2009 - Lobbied in support of bill that would address racial and ethnic disparities in care. S. 979/HR 2360, Small Business Health Options Programs Act - Lobbied in support of bill that would establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable and accessible. H.R. 3200, America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/S.1796 America's Healthy Future Act ) Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, ending rating by health condition or any proxy, closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit or other transitional care provisions in medicare and expanding the asset limit to qualify for low-income programs in medicare, establishing CLASS program. S.1213, Patient-Centered Outcomes Research Act - Lobbied in support of bill that would create a public-private partnership to conduct and disseminate comparative effectiveness research. S. 726/H.R. 1427, Promoting Innovation and Access to Life Saving Medicines - Discussed legislation which would create a pathway for approval of safe, effective biosimilar and generic biologic drugs. H.R. 3090, Health Equity and Accountability Act - Discussed need to end racial and ethnic disparities in care. Labor, HHS, Education and Related Agencies Appropriations Act FY 2011 - Lobbied for funding for healthcare services, research and training involving NIH, AHRQ, CMS, HRSA, HHS and AOA. (no bill) H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation which makes improvements such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act.

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

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

H.R.3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long-term services and supports. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Discussed the need for bipartisan action on health care reform legislation, such as affordable and accessible quality healthcare with a focus on the 50-64 year old population. (no bill) Discussed healthcare reform and issues around the public plan option (no bill). S.1569/H.R.3185 Medicare Graduate Nursing Education Act - Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population. (no bill) S. 623/HR 1558, Pre-existing Condition Patient Protection Act of 2009 - Lobbied in support of bill that would prohibit insurers from denying health insurance or delaying coverage for people with pre-existing conditions. H.R. 2778, Health Equity and Accountability through Research Act of 2009 - Lobbied in support of bill that would address racial and ethnic disparities in care. S. 979/HR 2360, Small Business Health Options Programs Act - Lobbied in support of bill that would establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable and accessible. H.R. 3200, America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/S.1796 America's Healthy Future Act ) Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, ending rating by health condition or any proxy, closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit or other transitional care provisions in medicare and expanding the asset limit to qualify for low-income programs in medicare, establishing CLASS program. S.1213, Patient-Centered Outcomes Research Act - Lobbied in support of bill that would create a public-private partnership to conduct and disseminate comparative effectiveness research. S. 726/H.R. 1427, Promoting Innovation and Access to Life Saving Medicines - Discussed legislation which would create a pathway for approval of safe, effective biosimilar and generic biologic drugs. H.R. 3090, Health Equity and Accountability Act - Discussed need to end racial and ethnic disparities in care. Labor, HHS, Education and Related Agencies Appropriations Act FY 2011 - Lobbied for funding for healthcare services, research and training involving NIH, AHRQ, CMS, HRSA, HHS and AOA. (no bill) H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation which makes improvements such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act.

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

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

HR 1583 (McCarran-Ferguson). S 819 (Autism). HR 1253 (disclosure rules) HR 1691/S 688 (prohibit plan rescissions and establish minimum hospital stays for cancer patients) HR 1558/S623 ; also HR 1619, S. 643, HR 1092 (prohibit pre-existing condition exclusions). S. 442/ HR 1085 (prohibit aggregate lifetime limit) S. 697 /HR 1721 (Long Term Care) HR 975 (Mammography mandate) HR 1339 (Mandate to fcover deformities)

Client expense: $1,641,400 · Firm income: Not reported

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

Affordable Health Care for America Act (H.R. 3962) Affordable Health Choices Act (draft) Affordable Health Choices Act (S. 1679) America's Affordable Health Choices Act (H.R. 3200) America's Healthy Future Act (Senate Finance - unnumbered) Childhood Obesity Task Force Children's Health Insurance Program Reauthorization Act (S. 275/H.R. 2) Children's Health Protection Act (S. 643/H.R. 1619) Congenital Heart Futures Act (S. 621/H.R. 1570) Health Care and Education Reconciliation Act (H.R. 4872) Health Equity and Accountability Act (H.R. 3090) Health Insurance Coverage Protection Act (S. 442/H.R. 1085) Heart Disease Education, Analysis and Research, and Treatment for Women Act (HEART for Women Act) (S.422/H.R. 1032) Informed Consumer Choices in Health Care Act (S. 1050/H.R. 2427) Josh Miller HEARTS Act (S. 1197/H.R. 1380) National Atrial Fibrillation Awareness Month Resolution (H.Res.255) Patient Protection and Affordable Care Act (H.R. 3590) Preexisting Condition Exclusion Patient Protection Act (S. 623/H.R. 1558) Resolution Designating May 1 through May 7, 2009 as National Physical Education and Sports Week (S.RES.133/H.RES.503) Tri-Committee Health Care Reform Bill (House draft) Women's Health Insurance Fairness Act (S.969) Workplace Wellness Grants (H.R. 3962/H.R. 3590) Young Adult Healthcare Coverage Act of 2009 (H.R. 2831)

Client expense: $135,901 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)

H.R.914, Physician Workforce Enhancement Act of 2009, Addiction treatment workforce development. S.790, Health Access and Health Professions Supply Act of 2009, Addiction treatment workforce development. Add to #17 below: National Institute of Drug Abuse (NIDA); and Center for Substance Abuse Treatment (CSAT) H.R. 1092, No Discrimination in Health Insurance Act of 2009, Consumer and patient protections. HR 1558/S. 623, Pre-existing Condition Patient Protection Act, Consumer and patient protections. S. 442, Health Insurance Coverage Protection Act, Consumer and patient protections. H.R. 1253, Health Insurance Restrictions and Limitations Clarification Act of 2009, Consumer and patient protections. H.R.1085, Health Insurance Coverage Protection Act, Consumer and patient protections. S. 391, Healthy Americans Act, Health care reform. H.R. 193, AmeriCare Health Insurance Act of 2009, Health care reform. S. 1050, Informed Consumer Choices in Health Care Act of 2009, Discrimination in the private health insurance market related issues. H.R.756/S.660, National Pain Care Policy Act of 2009, Pain care related issues. H.R.3200, America's Affordable Health Choices Act of 2009, Addiction treatment issues. S.1679, Affordable Health Choices Act, Addiction treatment issues. Public Law 111-148, Patient Protection and Affordable Care Act, Addiction treatment issues. H.R.4872, Health Care Reconciliation Act of 2010, Addiction Treatment issues.

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), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

H.R .1558 & S. 623: Pre-existing Condition Patient Protection Act H.R. 1708 & S. 700: Ending the Medicare Disability Waiting Perion Act of 2009 H.R .1085 & S. 442: Health Insurance Coverage Protection Act H.R. 2408 7 S. 1545: Scleroderma Research and Awareness Act H.R. 3200: America Affordable Health Care Choices Act S. 1679: Affordable Health Choices Act H.R. 3962: Affordable Health Care for America Act H.R. 3590: Patient Protection and Affordable Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Biologicals S.623 E-Prescribing - Enhanced Health Care Value for All Act Comparative Effectiveness Research Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to estate tax, deferral, net operating loss, executive compensation, LIFO, and research & development (no specific legislation introduced) H.R. 3393/S. 1934, Foreign Account Tax Compliance Act of 2009 All tax-related provisions of the following bills: H.R. 1322, Emergency Retiree Health Benefits Protection Act of 2009 H.R. 1265/S. 506, Stop Tax Haven Abuse Act S. 722, Taxpayer Certainty and Relief Act of 2009 H.R. 2452/S. 823, Net Operating Loss (NOL) Carryback Act H.R. 422, to amend the Internal Revenue Code of 1986 to extend the research credit through 2010 and to increase and make permanent the alternative simplified research credit S. 1203, Grow Research Opportunities With Taxcredits' Help Act S. 996, S Corporation Modernization Act of 2009 H.R. 436, Certain Estate Tax Relief Act of 2009 H.R. 3590, Service Members Home Ownership Tax Act of 2009 S. 1678, to amend the Internal Revenue Code of 1986 to extend the first-time homebuyer tax credit, and for other purposes H.R. 3463, Death Tax Repeal Permanency Act of 2009 H.R. 3607, FY 2010 Federal Aviation Administration Extension Act H.R. 3617, Surface Transportation Extension Act of 2009 S. 1796, America's Healthy Future Act of 2009 H.R. 3200, America's Affordable Health Choices Act of 2009 H.R. 4213, Tax Extenders Act of 2009 H.R. 4154, Permanent Estate Tax Relief for Families, Farmers, and Small Businesses Act of 2009 H.R. 3962, Affordable Health Care for America Act H.R. 4191, Let Wall Street Pay for the Restoration of Main Street Act of 2009 H.R. 3548, Worker, Homeownership, and Business Assistance Act of 2009 S. 1792, a bill to amend the Internal Revenue Code of 1986 to modify the requirements for windows, doors, and skylights to be eligible for the credit for non business energy property H.R. 3548, Worker, Homeownership, and Business Tax Act of 2009 S. 623, Patient Protection and Affordable Care Act H.R. 3905, Estate Tax Relief Act of 2009 H.R. 4173, Wall Street Reform and Consumer Protection Act of 2009 H.R. 3408/S. 2882, Taxpayer Responsibility, Accountability, and Consistency Act of 2009 H.R. 275/S. 292, Withholding Tax Relief Act of 2009 General background on tax gap proposals for small business, 1099 Corporate Reporting and possible tax extenders (no specific legislation introduced)

Client expense: $71,190,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Maritime Administration (MARAD), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), St. Lawrence Seaway Development Corporation, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Heart Disease Education, Analysis and Research, and Treatment for Women Act (HEART for Women Act) (S.422/H.R. 1032) National CPR-AED Awareness Week (S.CON.RES. 54/H.CON.RES. 215) Josh Miller HEARTS Act (H.R. 1380) Resolution for American Heart Month (H.CON.RES. 112) Workplace Wellness Resolution (S.RES. 673/H.CON.RES. 405) Sudden Cardiac Arrest Awareness Resolution (S.CON.RES 93/H.CON.RES. 393) Children's Health Insurance Program Reauthorization Act (S. 275/H.R. 2) Children's Health Protection Act (S. 643/H.R. 1619) Health Insurance Coverage Protection Act (S. 442/H.R. 1085) Preexisting Condition Exclusion Patient Protection Act (S. 623/H.R. 1558) Unique Device Identifier (FDA-2008-N-0061) 2010 Dietary Guidelines for Americans

Client expense: $240,666 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE