Long-Term Care Affordability and Security Act of 2009

H.R. 4872: Health Care and Education Reconciliation Act H.R. 3590: Patient Protection and Affordable Care Act S.702 A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term insurance.

Client expense: $500,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE

H.R. 3590: the Patient Protection and Affordable Care Act H.R. 4872: the Health Care and Education Reconciliation Act of 2010 H.R. 5712: Veterans', Seniors', Childrens', Health Tech. Corrections Act of 2010. S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S.1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older American with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuing adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title of certain non-instutional full-benefit dual eligible individuals. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679: An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experiences health care professionals. S.1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. H.R. 2: To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. S. 795: A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.631: A bill to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 458: A bill to amend the False Claims Act. H.R. 2043: To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students, and for other purposes. H.R. 1642: To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 1494: 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. H.R. 448: To protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes. H.R. 3191: 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. S. 386: A bill to improve enforcement of mortgage fraud, securities fraud, financial institutional fraud, and other frauds related to federal assistance and relief programs, for the recovery of funds lost to these frauds, and for other purposes. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010. H.R. 6130: The Strengthening Medicare Anti-Fraud Measures Act of 2010. H.R. 6261: To amend titles XVIII and XIX of the Social Security Act to improve oversight of nursing facilities under the Medicare and Medicaid programs by ensuring adequate, trained surveyors, and for other purposes. H.R. 1586: FAA Air Transportation Modernization and Safety Improvement Act-which provides for an extension of additional FMAP support until June 2011. H.R. 6074: Enhancing Quality through Survey System Improvements Act of 2010. H.R. 5950: A bill introduced on June 29th, Rep Joe Courtney (D-CT), introduced the Improving Access to Medicare Coverage Act of 2010, which requires observation stays exceeding 24 hours to be considered as inpatient days for the purpose of meeting the 3-day inpatient hospital requirement for Medicare coverage of SNF stays. H.R. 5546: To provide for the establishment of a fraud, waste and abuse detection and mitigation program for the Medicare program under Titles XVIII of the Social Security Act. S. 2781: Rosa's Law. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010. H.R. 4494: Medicare and Medicaid Extenders Act of 2010. H.R. 2520: the Patient's Choice Act. H.R. 4529: Roadmap for America's Future Act of 2010. This bill raises several major concerns for LTC financing, including impacts on providers and beneficiaries of all types.

Client expense: $500,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE

Implementation of healthcare reform laws - Executive Branch actions re PL 111-148 and PL 111-152. Repeal Patient Protection and Affordable Health Care Acts (PL 111-148/PL 111-152) - HR 4901, To repeal the Patient Protection and Affordable Care Act; HR 4903, To repeal the Patient Protection and Affordable Care Act; HR 4910, To repeal the Patient Protection and Affordable Care Act and enact the Empowering Patients First Act in order to provide incentives to encourage health insurance coverage; HR 4919, To repeal the Patient Protection and Affordable Care Act; HR 4972, To repeal the Patient Protection and Affordable Care Act; HR 5005, To repeal the Patient Protection and Affordable Care Act; HR 5073, To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 and enact the OPTION Act of 2009; HR 5216, To repeal the Patient Protection and Affordable Care Act; HR 5421, To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, repeal the 7.5 percent threshold on the deduction for medical expenses, provide for increased funding for high-risk pools, allow acquiring health insurance across State lines, and allow for the creation of association health plans; HR 5424, Reform Americans Can Afford Act of 2010 ; HR 5444, Private Option Health Care Act; HR 6355, STAT Act of 2010; S 3147, Patient Choice Restoration Act; S 3152, A bill to repeal the Patient Protection and Affordable Care Act. *Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. *Tax incentives for LTC insurance - 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; 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; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; 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 insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 6234, Comprehensive Long-Term Care Support Act of 2010. *HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. *HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. *Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. *Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. *Tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits - S 2958, CARE Act of 2010. *Changes to premium tax, high-value health plan tax - HR 4872, Health Care and Education Reconciliation Act of 2010. *Repeal HSA and FSA restrictions - HR 5923, To amend the Patient Protection and Affordable Care Act to repeal certain limitations on tax health care benefits; S 3673, Patients' Freedom to Choose Act. *Treatment of high deductible health plans as qualified health plans, repeal of HSA and FSA restrictions - HR 5936, Restoring Assistance for Families' and Seniors' Health Expenses Act of 2010. *TAA health coverage tax credits - HR 6517, Omnibus Trade Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposals relating to long-term care insurance, disability insurance, and health insurance generally. S. 702/H.R. 2096, Long-term Care Affordability and Security Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

Proposals relating to long-term care insurance, disability insurance, and health insurance generally. S. 702/H.R. 2096, Long-term Care Affordability and Security Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

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. 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. 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.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. 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 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 - Enacts 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

H.R.1192 To amend the Internal Revenue Code of 1986 to provide more help to Alzheimer's disease caregivers. Long Term Care Trust Accounts Act S.702 Long Term Care Affordability and Security Act S.697 CLASS Act S1177 Confidence In LongTerm Care Insurance Act of 2009 H.R.519 To authorize additional appropriations for the family caregiver support program under the Older Americans Act of 1965, and for the National Clearinghouse for Long-Term Care Information, for fiscal years 2010, 2011, and 2012 H.R.2096 Long Term Care Cafeteria and Flexible Spending Account H.R.1721 CLASS Act H.R.897 Deduction for Long Term Care Insurance Premiums under Cafeteria Plans and Flexible Spending Arrangements S.1626 Long Term Care insurance Integrity Act of 2009 S.1796 An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes H.R.3200 America's Affordable Health Choices Right-to-Know Act of 2009 S.1679 Affordable Health Choices Act H.R.3962 Affordable Healthcare for America Act S1728 Patient Protection and Affordable Care Act of 2009 HR5890 Long Term Insurance Reform Act of 2010

Client expense: $900,000 · Firm income: Not reported

Government targets: Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

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

H.R.1192 To amend the Internal Revenue Code of 1986 to provide more help to Alzheimer's disease caregivers. Long Term Care Trust Accounts Act S.702 Long Term Care Affordability and Security Act S.697 CLASS Act S1177 Confidence In LongTerm Care Insurance Act of 2009 H.R.519 To authorize additional appropriations for the family caregiver support program under the Older Americans Act of 1965, and for the National Clearinghouse for Long-Term Care Information, for fiscal years 2010, 2011, and 2012 H.R.2096 Long Term Care Cafeteria and Flexible Spending Account H.R.1721 CLASS Act H.R.897 Deduction for Long Term Care Insurance Premiums under Cafeteria Plans and Flexible Spending Arrangements S.1626 Long Term Care insurance Integrity Act of 2009 S.1796 An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes H.R.3200 America's Affordable Health Choices Right-to-Know Act of 2009 S.1679 Affordable Health Choices Act H.R.3962 Affordable Healthcare for America Act S1728 Patient Protection and Affordable Care Act of 2009 HR5890 Long Term Insurance Reform Act of 2010

Client expense: $980,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 897, Long-Term Care and Retirement Security Act (Putnam) tax incentives for LTC insurance; H.R. 1891, Sunset of Life Protection Act (Alexander) tax incentives for LTC insurance (cont.) H.R. 2096, Long-Term Care Affordability and Security Act (Pomeroy) tax incentives for LTC insurance; H.R. 2974: HSAs for Veterans (Campbell) HSA contributions by veterans; H.R. 3478, Patient-Controlled Healthcare Protection Act (Gohmert) HSA improvements, transparency; H.R. 3490, Wellness Programs (Johnson) tax incentives for employer-sponsored wellness programs; H.R. 3508, Healthy Savings Act (Paulsen) HSA improvements; H.R. 3610, Health Savings and Affordability Act (Austria) health insurance tax deduction, HSAs; H.R. 3971, Health Savings Account Expansion Act (Flake) HSA improvements; H.R. 5923 (Paulsen) repeal HSA and FSA restrictions; H.R. 5936, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) treatment of high deductible health plans as qualified health plans, repeal of HSA and FSA restrictions; H.R. 6234, Comprehensive Long-Term Care Support Act (Herseth Sandlin) tax incentives for LTC insurance; S. 94, Long-Term Care Family Accessibility Act (Vitter) tax incentives for LTC insurance; S. 702, Long-Term Care Affordability and Security Act (Grassley) tax incentives for LTC insurance; S. 2958 CARE Act (Menendez) tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits; S. 3673, Patients Freedom to Choose Act (Hutchison) -- repeal HSA and FSA restrictions TAX (Regulatory) Issues relating to Health Savings Accounts; issues related to COBRA subsidy requirements; issues relating to withholding of government contract payments; pre-existing condition insurance plans, internal claims and appeals and external review processes, coverage of preventive services; pre-existing condition exclusions, lifetime and annual dollar limits on benefits, rescissions, and patient protections; grandfathered health plan provisions; dependent coverage; and other issues relating to health care reform implementation; issues relating to IRC Sec 162(m) reporting; and other issues relating to health care reform implementation.

Client expense: $2,330,000 · Firm income: Not reported

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

H.R. 1961 - Savings for American Families' Future Act of 2009; entire bill H.R. 2021 - Savings Recovery Act; entire bill H.R. 2096 - Long-Term Care Affordability and Security Act of 2009; entire bill H.R. 2637 - To amend the Internal Revenue Code of 1986 to increase the age at which distributions from qualified retirement plans are required to begin and to extend the waiver of required minimum distribution rules for certain retirement plans and accounts through 2010; entire bill H.R. 2748 - Retirement Security Needs Lifetime Pay Act; entire bill H.R. 2779 Defined Contribution Plan Fee Transparency Act; provisions relating to fee disclosure H.R. 2989 - 401(k) Fair Disclosure and Pension Security Act of 2009; provisions relating to fee disclosures and investment advice H.R. 3429 - Generate Retirement Ownership Through Long-Term Holding Act of 2009; entire bill H.R. 3551 - Senior Investment Protection Act of 2009; entire bill H.R. 3936 Preserve Benefits and Jobs Act of 2009; provisions relating to employer-provided pension plans and retirement savings H.R. 4213 American Jobs and Closing Tax Loopholes Act of 2010; provisions relating to fee disclosure H.R. 4126 - Retirement Fairness Act of 2009; entire bill H.R. 4146 - Sensible Transparency for Retirement Plans Act of 2009; entire bill H.R. 4742 Small Businesses Add Value for Employees (SAVE) Act; entire bill H.R. 6099 - Automatic IRA Act of 2010; entire bill S. 401 - Defined Contribution Fee Disclosure Act of 2009; entire bill S. 702 - Long-Term Care Affordability and Security Act of 2009; entire bill S. 906 - Senior Investor Protection Act; entire bill S. 1082 - The Generating Retirement Ownership Through Long-Term Holding Act; entire bill S. 1297 - Retirement Security for Life Act; entire bill S. 1661 - Senior Investment Protection Act of 2009; entire bill S. 2832 Lifetime Income Disclosure Act; entire bill S. 3760 - Automatic IRA Act of 2010; entire bill Administrations Budget provisions relating to Auto IRA proposal

Client expense: $580,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposals relating to long-term care insurance, disability insurance, and health insurance generally. S. 702/H.R. 2096, Long-term Care Affordability and Security Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposals relating to long-term care insurance, disability insurance, and health insurance generally. S. 702/H.R. 2096, Long-term Care Affordability and Security Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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. 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. 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.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. 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 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 - Enacts 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

- 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" a/k/a "America's Affordable Health Care Act", regarding all provisions. - S 391/HR 1321, "A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away" a/k/a "Healthy Americans Act", regarding all provisions. - HR 1, "Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes" a/k/a "American Recovery and Reinvestment Act of 2009", regarding COBRA Benefits Section 3002 and Comparative Effectiveness Council Section 9201. - HR 2096/S 702, "To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance", a/k/a "The Long-Term Care Affordability and Security Act of 2009", regarding all provisions. - S 1177, "A bill to improve consumer protections for purchasers of long-term care insurance, and for other purposes", a/k/a "Long-Term Care Insurance Act of 2009", regarding all provisions. - HR 2520, "To provide comprehensive solutions for the health care system of the United States, and for other purposes", a/k/a "Patients Choice Act", regarding all provisions. - S 1099, "A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes", a/k/a "Patients Choice Act", regarding all provisions. - S 1213, "A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes", a/k/a "Patient-Centered Outcome Research Act of 2009", regarding all provisions. - HR 1721/S 697, "A bill to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes", a/k/a "Community Living Assistance Services and Supports Act", regarding all provisions. - S 1679, "An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce", a/k/a "Affordable Health Choices Act", regarding all provisions. - S 1730, "A bill to provide for minimum loss ratios for health insurance coverage", a/k/a "Fairness in Health Insurance Act of 2009", regarding all provisions. - HR 3200, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a "America's Affordable Health Choices Act of 2009" regarding all provisions. - HR 3962, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a, "Affordable Health Care for America Act", regarding all provisions. - HR 3590, "Patient Protection & Affordable Care Act", regarding all provisions. - S 1636, "A bill to develop a model disclosure form to assist consumers in purchasing long-term care insurance", a/k/a "Long-Term Care Insurance Consumer Right-to-Know Act", regarding all provisions. - HR 4372, "Health Care and Education Affordability Reconciliation Act", regarding all provisions.

Client expense: $1,150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC), U.S. Trade Representative (USTR)

Implementation of healthcare reform legislation; premium tax, high-value health plan tax, tax credits, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - Executive Branch actions re PL 111-148 and PL 111-152. *Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. *Tax incentives for LTC insurance - 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; 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; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; 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 insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 6234, Comprehensive Long-Term Care Support Act of 2010. *HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. *HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. *Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. *Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. *Tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits - S 2958, CARE Act of 2010. *Changes to premium tax, high-value health plan tax - HR 4872, Health Care and Education Reconciliation Act of 2010. *Repeal HSA and FSA restrictions - HR 5923, To amend the Patient Protection and Affordable Care Act to repeal certain limitations on tax health care benefits; S 3673, Patients' Freedom to Choose Act. *Treatment of high deductible health plans as qualified health plans, repeal of HSA and FSA restrictions - HR 5936, Restoring Assistance for Families' and Seniors' Health Expenses Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4872: Health Care and Education Reconciliation Act H.R. 3590: Patient Protection and Affordable Care Act S.702 A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term insurance.

Client expense: $500,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE

H.R. 3590: the Patient Protection and Affordable Care Act H.R. 4872: the Health Care and Education Reconciliation Act of 2010 S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the trageting of the enforcement of requirements with respect to such facilities. S.1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older American with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuing adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title of certain non-instutional full-benefit dual eligible individuals. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 4505: A bill that will allow state veterans homes to provide services to non-veteran parents of any child (one or more) who died while serving in the armed forces, has passed in the House and Senate. S. 1679: An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experiences health care professionals. S.1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. H.R. 2: To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. S. 795: A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.631: A bill to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 458: A bill to amend the False Claims Act. H.R. 2043: To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students, and for other purposes. H.R. 1642: To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 1494: 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. H.R. 448: To protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes. H.R. 3191: 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. S. 386: A bill to improve enforcement of mortgage fraud, securities fraud, financial institutional fraud, and other frauds related to federal assistance and relief programs, for the recovery of funds lost to these frauds, and for other purposes. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010. H.R. 6130: The Strengthening Medicare Anti-Fraud Measures Act of 2010. H.R. 6261: To amend titles XVIII and XIX of the Social Security Act to improve oversight of nursing facilities under the Medicare and Medicaid programs by ensuring adequate, trained surveyors, and for other purposes. H.R. 5712: Veterans', Seniors', Childrens', Health Tech. Corrections Act of 2010. H.R. 1586: FAA Air Transportation Modernization and Safety Improvement Act-which provides for an extension of additional FMAP support until June 2011. H.R. 6074: Enhancing Quality through Survey System Improvements Act of 2010. H.R. 5950: A bill introduced on June 29th, Rep Joe Courtney (D-CT), introduced the Improving Access to Medicare Coverage Act of 2010, which requires observation stays exceeding 24 hours to be considered as inpatient days for the purpose of meeting the 3-day inpatient hospital requirement for Medicare coverage of SNF stays. H.R. 5850: To solve the staffing issues and backlog in processing HUD 232 loans. H.R. 5950: Improving Access to Medicare Coverage Act of 2010. H.R. 5546: To provide for the establishment of a fraud, waste and abuse detection and mitigation program for the Medicare program under Titles XVIII of the Social Security Act. S. 2781: Rosa's Law. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010.

Client expense: $500,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE

Community Pharmacy Fairness Act of 2009 H.R. 1204 Healthy Americans Act H.R. 1321 Emergency Retiree Health Benefits Protection Act H.R. 1322 Long-Term Care Affordability and Security Act of 2009 H.R. 2096 Healthy Families Act H.R. 2460 The Patients Choice Act H.R. 2520 Family Leave Insurance Act of 2009 H.R. 1723 Tax Equity for Health Plan Beneficiaries Act of 2009 H.R. 2625 Prevent application of ERISA preemption to state law causes of action - H.R. 3925 Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 -H.R. 3962/Public Law No: 111-192 Common Sense Health Care Reform and Affordability Act H.R. 4038 American Workers, State, and Business Relief Act H.R. 4213, Unemployment Compensation Extension Act of 2010 Public Law No: 111-205 Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law No: 111-152 Senate Healthy Americans Act - S. 391 Long-Term Care Affordability and Security Act of 2009 S. 702 The Patients Choice Act S. 1099 Healthy Families Act S. 1152 Tax Equity for Health Plan Beneficiaries Act of 2009 S. 1153 Confidence in Long-Term Care Insurance Act S. 1177 Patient Centered Outcomes Research Act S. 1213 American Jobs Protection Act S. 3501 American Workers, State, and Business Relief Act H.R. 4213 & substitute amendment Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law 111-152 Regulatory communication with covered federal officials on legislative issues Proposed rule on application of ERISA to state/local health reform efforts. COBRA premium subsidy assistance extension American Recovery and Reinvestment Act of 2009 (ARRA) included in the Department of Defense Appropriations Act of 2010 Guidance for and implementation of the Patient Protection and Affordable Care Act (PPACA) & the Health Care and Education Reconciliation Act of 2010 (HCERA) employer responsibility provisions, tax treatment of certain plans, transition period and good faith compliance standard, CLASS Act provisions, Early Retiree Reinsurance Program (ERRP), retiree only plans, grandfathered plans, grandfathering rules as applied to collectively bargained health plans, coverage of adult children, medical loss ratios (MLRs), limited benefit plans, quality improvement initiatives, meaningful use rules, preventive care, preexisting conditions, annual & lifetime limits, patient protections, claims and appeals procedures, external review, health information technology & electronic health records, health literacy and insurance exchanges Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 comments on Interim Final Regulations. Health Information Technology for Economic and Clinical Health (HITECH) Act

Client expense: $199,380 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

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

H.R. 897, Long-Term Care and Retirement Security Act (Putnam) tax incentives for LTC insurance; (cont.) H.R. 1891, Sunset of Life Protection Act (Alexander) tax incentives for LTC insurance; H.R. 2096, Long-Term Care Affordability and Security Act (Pomeroy) tax incentives for LTC insurance; H.R. 2974: HSAs for Veterans (Campbell) HSA contributions by veterans; H.R. 3478, Patient-Controlled Healthcare Protection Act (Gohmert) HSA improvements, transparency; H.R. 3490, Wellness Programs (Johnson) tax incentives for employer-sponsored wellness programs; H.R. 3508, Healthy Savings Act (Paulsen) HSA improvements; H.R. 3590, Patient Protection and Affordable Care Act (Reid) premium tax, high-value health plan tax, tax credits, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses; H.R. 3610, Health Savings and Affordability Act (Austria) health insurance tax deduction, HSAs; H.R. 3971, Health Savings Account Expansion Act (Flake) HSA improvements; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to premium tax, high-value health plan tax; S. 94, Long-Term Care Family Accessibility Act (Vitter) tax incentives for LTC insurance; S. 702, Long-Term Care Affordability and Security Act (Grassley) tax incentives for LTC insurance; S. 2958 CARE Act (Menendez) tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits TAX (Regulatory) Issues relating to Health Savings Accounts; issues related to COBRA subsidy requirements; issues relating to withholding of government contract payments; and issues relating to health care reform implementation.

Client expense: $2,290,000 · 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

- 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" a/k/a "America's Affordable Health Care Act", regarding all provisions. - S 391/HR 1321, "A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away" a/k/a "Healthy Americans Act", regarding all provisions. - HR 1, "Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes" a/k/a "American Recovery and Reinvestment Act of 2009", regarding COBRA Benefits Section 3002 and Comparative Effectiveness Council Section 9201. - HR 2096/S 702, "To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance", a/k/a "The Long-Term Care Affordability and Security Act of 2009", regarding all provisions. - S 1177, "A bill to improve consumer protections for purchasers of long-term care insurance, and for other purposes", a/k/a "Long-Term Care Insurance Act of 2009", regarding all provisions. - HR 2520, "To provide comprehensive solutions for the health care system of the United States, and for other purposes", a/k/a "Patients Choice Act", regarding all provisions. - S 1099, "A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes", a/k/a "Patients Choice Act", regarding all provisions. - S 1213, "A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes", a/k/a "Patient-Centered Outcome Research Act of 2009", regarding all provisions. - HR 1721/S 697, "A bill to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes", a/k/a "Community Living Assistance Services and Supports Act", regarding all provisions. - S 1679, "An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce", a/k/a "Affordable Health Choices Act", regarding all provisions. - S 1730, "A bill to provide for minimum loss ratios for health insurance coverage", a/k/a "Fairness in Health Insurance Act of 2009", regarding all provisions. - HR 3200, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a "America's Affordable Health Choices Act of 2009" regarding all provisions. - HR 3962, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a, "Affordable Health Care for America Act", regarding all provisions. - HR 3590, "Patient Protection & Affordable Care Act", regarding all provisions. - S 1636, "A bill to develop a model disclosure form to assist consumers in purchasing long-term care insurance", a/k/a "Long-Term Care Insurance Consumer Right-to-Know Act", regarding all provisions. - HR 4372, "Health Care and Education Affordability Reconciliation Act", regarding all provisions.

Client expense: $1,270,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC), U.S. Trade Representative (USTR)

H.R. 1961 - Savings for American Families' Future Act of 2009; entire bill H.R. 2021 - Savings Recovery Act; entire bill H.R. 2096 - Long-Term Care Affordability and Security Act of 2009; entire bill H.R. 2637 - To amend the Internal Revenue Code of 1986 to increase the age at which distributions from qualified retirement plans are required to begin and to extend the waiver of required minimum distribution rules for certain retirement plans and accounts through 2010; entire bill H.R. 2748 - Retirement Security Needs Lifetime Pay Act; entire bill H.R. 2779 Defined Contribution Plan Fee Transparency Act; provisions relating to fee disclosure H.R. 2989 - 401(k) Fair Disclosure and Pension Security Act of 2009; provisions relating to fee disclosures and investment advice H.R. 3429 - Generate Retirement Ownership Through Long-Term Holding Act of 2009; entire bill H.R. 3551 - Senior Investment Protection Act of 2009; entire bill H.R. 3936 Preserve Benefits and Jobs Act of 2009; provisions relating to employer-provided pension plans and retirement savings H.R. 4213 American Jobs and Closing Tax Loopholes Act of 2010; provisions relating to fee disclosure H.R. 4126 - Retirement Fairness Act of 2009; entire bill H.R. 4146 - Sensible Transparency for Retirement Plans Act of 2009; entire bill H.R. 4742 - Small Businesses Add Value for Employees (SAVE) Act; entire bill S. 401 - Defined Contribution Fee Disclosure Act of 2009; entire bill S. 702 - Long-Term Care Affordability and Security Act of 2009; entire bill S. 906 - Senior Investor Protection Act; entire bill S. 1082 - The Generating Retirement Ownership Through Long-Term Holding Act; entire bill S. 1297 - Retirement Security for Life Act; entire bill S. 1661 - Senior Investment Protection Act of 2009; entire bill S. 2832 Lifetime Income Disclosure Act; entire bill Administrations Budget provisions relating to Auto IRA proposal

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Community Pharmacy Fairness Act of 2009 H.R. 1204 Healthy Americans Act H.R. 1321A Emergency Retiree Health Benefits Protection Act H.R. 1322 Family Leave Insurance Act of 2009 H.R. 1723 Long-Term Care Affordability and Security Act of 2009 H.R. 2096 Healthy Families Act H.R. 2460 The Patients Choice Act H.R. 2520 Tax Equity for Health Plan Beneficiaries Act of 2009 H.R. 2625 Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law No: 111-152 Prevent application of ERISA preemption to state law causes of action - H.R. 3925 Affordable Health Care for America Act H.R. 3962 Common Sense Health Care Reform and Affordability Act H.R. 4038 American Workers, State, and Business Relief Act H.R. 4213, & substitute amendment Jobs for Main Street Act House Amendment to the Senate Amendment to H.R. 2847 Senate Healthy Americans Act - S. 391 Long-Term Care Affordability and Security Act of 2009 S. 702 The Patients Choice Act S. 1099 Healthy Families Act S. 1152 Tax Equity for Health Plan Beneficiaries Act of 2009 S. 1153 Confidence in Long-Term Care Insurance Act S. 1177 Patient Centered Outcomes Research Act S. 1213 The COBRA Subsidy Extension and Enhancement Act S. 2730 Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law 111-152 American Workers, State, and Business Relief Act H.R. 4213 & substitute amendment Temporary Extension Act of 2010 H.R. 4691 Public Law No: 111-144 COBRA Subsidy Program extension Continuing Extension Act H.R. 4851: short-term COBRA extension The Democratic Substitute/Revised Version to the Continuing Extension Act H.R. 4851 Regulatory communication with covered federal officials on legislative issues Proposed rule on application of ERISA to state/local health reform efforts. COBRA premium subsidy assistance extension American Recovery and Reinvestment Act of 2009 (ARRA) included in the Department of Defense Appropriations Act of 2010. Guidance for and implementation of the Patient Protection and Affordable Care Act (PPACA) & the Health Care and Education Reconciliation Act of 2010 (HCERA) employer responsibility provisions, tax treatment of certain plans, transition period and good faith compliance standard, CLASS Act provisions, Early Retiree Reinsurance Program (ERRP), grandfathered plans, grandfathering rules as applied to collectively bargained health plans, coverage of adult children, medical loss ratios (MLRs), quality improvement initiatives, retiree-only plans, preexisting conditions, annual & lifetime limits, patient protections. Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 comments on Interim Final Regulations. Genetic Information Nondiscrimination Act (GINA) of 2008

Client expense: $222,965 · Firm income: Not reported

Government targets: Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of, Vice President of the U.S., White House Office

H.R. 4872: Health Care and Education Reconciliation Act H.R. 3590: Patient Protection and Affordable Care Act S.702 A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term insurance.

Client expense: $480,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

H.R. 3590: the Patient Protection and Affordable Care Act H.R. 4872: the Health Care and Education Reconciliation Act of 2010 S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the trageting of the enforcement of requirements with respect to such facilities. S.1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure ofr delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older American with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuing adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute edler abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title of certain non-instutional full-benefit dual eligible individuals. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679: An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experiences health care professionals. S.1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. H.R. 2: To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. S. 795: A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.631: A bill to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 458: A bill to amend the False Claims Act. H.R. 2043: To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students, and for other purposes. H.R. 1642: To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 1494: To ensure that a private for-profit nursing home affected by a major disaster receives the same rreimbursement as a public nursing home affected by a major disaster. H.R. 448: To protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes. H.R. 3191: 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. S. 386: A bill to improve enforcement of mortgage fraud, securities fraud, financial institutional fraud, and other frauds related to federal assistance and relief programs, for the recovery of funds lost to these frauds, and for other purposes. H.R. 5457: Nursing Home Patient and Medicaid Assistance Act of 2010.

Client expense: $480,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

Healthcare reform and international health plans in PL 111-148 - Executive Branch actions re these issues. *Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. *Tax incentives for LTC insurance - 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; 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; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; 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 insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. *HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. *HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. *Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. *Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. *Tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits - S 2958, CARE Act of 2010. *Premium tax, high-value health plan tax, tax credits, LTC insurance in cafeteria plans, FSA limits, tax exclusiong for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - HR 3590, Patient Protection and Affordable Care Act . *Changes to premium tax, high-value health plan tax - HR 4872, Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

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. 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. 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.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. 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 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

S 702, Long Term Care Affordability and Security Act, all provisions. S 3590 (Pub. Law 111-148), Patient Protection and Affordable Health Care Act, provisions related to long-term care

Client expense: $1,350,000 · Firm income: Not reported

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

Proposals relating to long-term care insurance, disability insurance, and health insurance generally. S. 702/H.R. 2096, Long-term Care Affordability and Security Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposals relating to long-term care insurance, disability insurance, and health insurance generally. S. 702/H.R. 2096, Long-term Care Affordability and Security Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1192 To amend the Internal Revenue Code of 1986 to provide more help to Alzheimer's disease caregivers. Long Term Care Trust Accounts Act S.702 Long Term Care Affordability and Security Act S.697 CLASS Act S.1177 A bill to improve consumer protections for purchasers of long-term care insurance, and for other purposes. H.R.519 To authorize additional appropriations for the family caregiver support program under the Older Americans Act of 1965, and for the National Clearinghouse for Long-Term Care Information, for fiscal years 2010, 2011, and 2012. H.R.2096 Long Term Care Cafeteria and Flexible Spending Account H.R.1721 CLASS Act H.R.897 Deduction for Long Term Care Insurance Premiums under Cafeteria Plans and Flexible Spending Arrangements S.1626 Long Term Care insurance Integrity Act of 2009 S.1796 An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R.3200 America's Affordable Health Choices Right-to-Know Act of 2009 S.1679 Affordable Health Choices Act H.R.3962 Affordable Healthcare for America Act S1728 Patient Protection and Affordable Care Act of 2009

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

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

H.R. 4872, the Health Care and Education Reconciliation Act of 2010; H.R. 3590, Patient Protection and Affordable Care Act H.R. 2298, the Expanding Dependent and Child Care Act H.R. 1279, to amend the Internal Revenue Code of 1986 to increase the contribution limits to dependent care flexible spending accounts to provide for a carryover of unused dependent care. H.R. 2526, the Medical FSA Improvement Act S. 702, the Long-Term Care Affordability and Security Act S. 491/H.R. 1203, the Federal and Military Retiree Health Care Equity Act Continue the increased limit for tax-favored mass transit benefits (as enacted by the American Recovery and Reinvestment Act of 2009, Pub. L. No. 111-5 (February 17, 2009) beyond the current sunset date of December 31, 2010 Issues pertaining to account-based plans and excise tax on high-cost plans.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 519: ELDER CAREGIVER SUPPORT AND INFORMATION ENHANCEMENT ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE INFORMATION CLEARINGHOUSE HR 1721/S. 697: COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS ACT; PROVISIONS RELATED TO REFORM OF LONG TERM CARE FINANCING H.R. 1961: SAVINGS FOR AMERICAN FAMILIES FUTURE ACT OF 2009; PROVISIONS RELATED TO SAVERS' CREDIT H.R.1984: 401(K) FAIR DISCLOSURE FOR RETIREMENT SECURITY ACT OF 2009; PROVISIONS RELATED TO RETIREMENT PLAN FEE DISCLOSURE H.R. 1988: CONFLICTED INVESTMENT ADVICE PROHIBITION ACT OF 2009; PROVISIONS RELATED TO INVESTMENT ADVICE H.R. 2021: SAVINGS RECOVERY ACT OF 2009; PROVISIONS RELATED TO SAVERS CREDIT HR 2096/S 702: LONG TERM CARE AFFORDABILITY AND SECURITY ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE IN CAFETERIA PLANS AND FLEXIBLE SPENDING ARRANGEMENTS H.R. 2733/S. 1389: FIXED INDEXED ANNUITIES AND INSURANCE PRODUCTS CLASSIFICATION ACT OF 2009; PROVISIONS RELATED TO CLARIFICATION FOR FIXED ANNUITIES REGULATION H.R. 2748: RETIREMENT SECURITY NEEDS LIFETIME PAY ACT OF 2009; PROVISIONS RELATED TO TAX INCENTIVES FOR ANNUITIES H.R. 2779: DEFINED CONTRIBUTION PLAN FEE TRANSPARENCY ACT OF 2009; PROVISIONS RELATED TO 401(K) PLAN FEE DISCLOSURE H.R. 2792: RETIREMENT SAVINGS TRANSPARENCY ACT OF 2009; PROVISIONS RELATED TO PLAN FEE DISCLOSURE H.R. 2989: 401 (K) FAIR DISCLOSURE AND PENSION SECURITY ACT OF 2009; PROVISIONS RELATED TO RETIREMENT PLAN FEE DISCLOSURE H.R. 3551 /S. 1661/S. 906: SENIOR INVESTMENT PROTECTION ACT OF 2009; PROVISIONS RELATED TO PRODUCT SALES TO SENIORS, AND ANNUITIES SALES H.R. 3590: THE PATIENT PROTECTION AND AFFORDABLE CARE ACT; PROVISIONS RELATED TO LONG TERM CARE AND SUPPLEMENTAL PRODUCTS FINANCING, ANDMEDICARE TAX ON NONQUALIFIED ANNUITY INCOME H.R. 4126: RETIREMENT FAIRNESS ACT OF 2009; PROVISIONS RELATED TO MODIFICATION OF 401(K) PLAN RULES H.R. 4173: WALL STREET REFORM AND CONSUMER PROTECTION ACT OF 2009; PROVISIONS RELATED TO THE EXCLUSION OF RETIREMENT BENEFITS FROM CONSUMER FINANCIAL PROTECTION AGENCY, SUITIBILITY OF INSURANCE PRODUCT SALES TO SENIORS, AND SALE OF ANNUITIES H.R. 4626: HEALTH INSURANCE INDUSTRY FAIR COMPETITION ACT; PROVISIONS RELATED TO INSURANCE ANTI-TRUST REGULATIONS (MCCARRON-FERGUSON) H.R. 4742: SMALL BUSINESSES ADD VALUE FOR EMPLOYEES ACT OF 2009; PROVISIONS RELATED TO FOR SIMPLIFICATION OF SIMPLE IRAS, AND VOLUNTARY AUTO IRAS H.R. 4872: HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010; PROVISIONS RELATED TO LONG TERM CARE FINANCING WITHING HEALTH CARE REFORM, AND UNEARNED INCOME TAXATION S. 401: DEFINED CONTRIBUTION FEE DISCLOSURE ACT OF 2009; PROVISIONS RELATED TO 401(K) PLAN FEE DISCLOSURE S. 1177: CONFIDENCE IN LONG TERM CARE INSURANCE ACT OF 2009; PROVISIONS RELATED TO CONSUMER PROTECTION IN LONG TERM CARE S. 1226: LONG TERM CARE INSURANCE INTEGRITY ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE S. 1297: RETIREMENT SECURITY FOR LIFE ACT OF 2009; PROVISIONS RELATED TO NON-QUALIFIED ANNUITIES TAX INCENTIVES S.1636: LONG TERM CARE INSURANCE CONSUMER RIGHT-TO-KNOW ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE CONSUMER PROTECTIONS S. 2832: LIFETIME INCOME DISCLOSURE ACT; PROVISIONS RELATED TO ANNUITY ILLUSTRATION ON BENEFIT STATEMENTS S. 3217: RESTORING AMERICAN FINANCIAL STABILITY ACT OF 2010; PROVISIONS RELATED TO SENIOR INVESTOR PROTECTION ACT, AND EMPLOYER BENEFIT PLANS WITHIN CONSUMER FINANCIAL PROTECTION BUREAU

Client expense: $1,020,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 519: ELDER CAREGIVER SUPPORT AND INFORMATION ENHANCEMENT ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE INFORMATION CLEARINGHOUSE HR 1721/S. 697: COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS ACT; PROVISIONS RELATED TO REFORM OF LONG TERM CARE FINANCING H.R. 1961: SAVINGS FOR AMERICAN FAMILIES FUTURE ACT OF 2009; PROVISIONS RELATED TO SAVERS' CREDIT H.R.1984: 401(K) FAIR DISCLOSURE FOR RETIREMENT SECURITY ACT OF 2009; PROVISIONS RELATED TO RETIREMENT PLAN FEE DISCLOSURE H.R. 1988: CONFLICTED INVESTMENT ADVICE PROHIBITION ACT OF 2009; PROVISIONS RELATED TO INVESTMENT ADVICE H.R. 2021: SAVINGS RECOVERY ACT OF 2009; PROVISIONS RELATED TO SAVERS CREDIT HR 2096/S 702: LONG TERM CARE AFFORDABILITY AND SECURITY ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE IN CAFETERIA PLANS AND FLEXIBLE SPENDING ARRANGEMENTS H.R. 2733/S. 1389: FIXED INDEXED ANNUITIES AND INSURANCE PRODUCTS CLASSIFICATION ACT OF 2009; PROVISIONS RELATED TO CLARIFICATION FOR FIXED ANNUITIES REGULATION H.R. 2748: RETIREMENT SECURITY NEEDS LIFETIME PAY ACT OF 2009; PROVISIONS RELATED TO TAX INCENTIVES FOR ANNUITIES H.R. 2779: DEFINED CONTRIBUTION PLAN FEE TRANSPARENCY ACT OF 2009; PROVISIONS RELATED TO 401(K) PLAN FEE DISCLOSURE H.R. 2792: RETIREMENT SAVINGS TRANSPARENCY ACT OF 2009; PROVISIONS RELATED TO PLAN FEE DISCLOSURE H.R. 2989: 401 (K) FAIR DISCLOSURE AND PENSION SECURITY ACT OF 2009; PROVISIONS RELATED TO RETIREMENT PLAN FEE DISCLOSURE H.R. 3551 /S. 1661/S. 906: SENIOR INVESTMENT PROTECTION ACT OF 2009; PROVISIONS RELATED TO PRODUCT SALES TO SENIORS, AND ANNUITIES SALES H.R. 3590: THE PATIENT PROTECTION AND AFFORDABLE CARE ACT; PROVISIONS RELATED TO LONG TERM CARE AND SUPPLEMENTAL PRODUCTS FINANCING, ANDMEDICARE TAX ON NONQUALIFIED ANNUITY INCOME H.R. 4126: RETIREMENT FAIRNESS ACT OF 2009; PROVISIONS RELATED TO MODIFICATION OF 401(K) PLAN RULES H.R. 4173: WALL STREET REFORM AND CONSUMER PROTECTION ACT OF 2009; PROVISIONS RELATED TO THE EXCLUSION OF RETIREMENT BENEFITS FROM CONSUMER FINANCIAL PROTECTION AGENCY, SUITIBILITY OF INSURANCE PRODUCT SALES TO SENIORS, AND SALE OF ANNUITIES H.R. 4626: HEALTH INSURANCE INDUSTRY FAIR COMPETITION ACT; PROVISIONS RELATED TO INSURANCE ANTI-TRUST REGULATIONS (MCCARRON-FERGUSON) H.R. 4742: SMALL BUSINESSES ADD VALUE FOR EMPLOYEES ACT OF 2009; PROVISIONS RELATED TO FOR SIMPLIFICATION OF SIMPLE IRAS, AND VOLUNTARY AUTO IRAS H.R. 4872: HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010; PROVISIONS RELATED TO LONG TERM CARE FINANCING WITHING HEALTH CARE REFORM, AND UNEARNED INCOME TAXATION S. 401: DEFINED CONTRIBUTION FEE DISCLOSURE ACT OF 2009; PROVISIONS RELATED TO 401(K) PLAN FEE DISCLOSURE S. 1177: CONFIDENCE IN LONG TERM CARE INSURANCE ACT OF 2009; PROVISIONS RELATED TO CONSUMER PROTECTION IN LONG TERM CARE S. 1226: LONG TERM CARE INSURANCE INTEGRITY ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE S. 1297: RETIREMENT SECURITY FOR LIFE ACT OF 2009; PROVISIONS RELATED TO NON-QUALIFIED ANNUITIES TAX INCENTIVES S.1636: LONG TERM CARE INSURANCE CONSUMER RIGHT-TO-KNOW ACT OF 2009; PROVISIONS RELATED TO LONG TERM CARE CONSUMER PROTECTIONS S. 2832: LIFETIME INCOME DISCLOSURE ACT; PROVISIONS RELATED TO ANNUITY ILLUSTRATION ON BENEFIT STATEMENTS S. 3217: RESTORING AMERICAN FINANCIAL STABILITY ACT OF 2010; PROVISIONS RELATED TO SENIOR INVESTOR PROTECTION ACT, AND EMPLOYER BENEFIT PLANS WITHIN CONSUMER FINANCIAL PROTECTION BUREAU

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 897, Long-Term Care and Retirement Security Act (Putnam) tax incentives for LTC insurance; H.R. 1891, Sunset of Life Protection Act (Alexander) tax incentives for LTC insurance; (cont.) H.R. 2096, Long-Term Care Affordability and Security Act (Pomeroy) tax incentives for LTC insurance; H.R. 2974: HSAs for Veterans (Campbell) HSA contributions by veterans; H.R. 3478, Patient-Controlled Healthcare Protection Act (Gohmert) HSA improvements, transparency; H.R. 3490, Wellness Programs (Johnson) tax incentives for employer-sponsored wellness programs; H.R. 3508, Healthy Savings Act (Paulsen) HSA improvements; H.R. 3590, Patient Protection and Affordable Care Act (Reid) premium tax, high-value health plan tax, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses; H.R. 3610, Health Savings and Affordability Act (Austria) health insurance tax deduction, HSAs; H.R. 3962, Americas Affordable Health Choices Act (Dingell) FSA limits, health savings accounts, eligibility of OTC drugs as tax-free expense; H.R. 3971, Health Savings Account Expansion Act (Flake) HSA improvements; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to premium tax, high-value health plan tax; S. 94, Long-Term Care Family Accessibility Act (Vitter) tax incentives for LTC insurance; S. 702, Long-Term Care Affordability and Security Act (Grassley) tax incentives for LTC insurance; S. 1679, Affordable Health Choices Act (Harkin) LTC insurance in cafeteria plans; S. 1796, Americas Healthy Future Act (Baucus) high-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses; S. 2958 CARE Act (Menendez) tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits TAX (Regulatory) Issues relating to Health Savings Accounts; issues related to COBRA subsidy requirements; and issues relating to withholding of government contract payments.

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

- Health Care Reform - 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" a/k/a "America's Affordable Health Care Act", regarding all provisions. - S 391/HR 1321, "A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away" a/k/a "Healthy Americans Act", regarding all provisions. - HR 1, "Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes" a/k/a "American Recovery and Reinvestment Act of 2009", regarding COBRA Benefits Section 3002 and Comparative Effectiveness Council Section 9201. - HR 2096/S 702, "To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance", a/k/a "The Long-Term Care Affordability and Security Act of 2009", regarding all provisions. - S 1177, "A bill to improve consumer protections for purchasers of long-term care insurance, and for other purposes", a/k/a "Long-Term Care Insurance Act of 2009", regarding all provisions. - HR 2520, "To provide comprehensive solutions for the health care system of the United States, and for other purposes", a/k/a "Patients Choice Act", regarding all provisions. - S 1099, "A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes", a/k/a "Patients Choice Act", regarding all provisions. - S 1213, "A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes", a/k/a "Patient-Centered Outcome Research Act of 2009", regarding all provisions. - HR 1721/S 697, "A bill to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes", a/k/a "Community Living Assistance Services and Supports Act", regarding all provisions. - S 1679, "An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce", a/k/a "Affordable Health Choices Act", regarding all provisions. - S 1730, "A bill to provide for minimum loss ratios for health insurance coverage", a/k/a "Fairness in Health Insurance Act of 2009", regarding all provisions. - HR 3200, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a "America's Affordable Health Choices Act of 2009" regarding all provisions. - HR 3962, "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes", a/k/a, "Affordable Health Care for America Act", regarding all provisions. - HR 3590, "Patient Protection & Affordable Care Act", regarding all provisions. - S 1636, "A bill to develop a model disclosure form to assist consumers in purchasing long-term care insurance", a/k/a "Long-Term Care Insurance Consumer Right-to-Know Act", regarding all provisions. - HR 4372, "Health Care and Education Affordability Reconciliation Act", regarding all provisions.

Client expense: $1,240,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC), U.S. Trade Representative (USTR)

H.R. 1961 - Savings for American Families' Future Act of 2009; entire bill H.R. 2021 - Savings Recovery Act; entire bill H.R. 2096 - Long-Term Care Affordability and Security Act of 2009; entire bill H.R. 2748 - Retirement Security Needs Lifetime Pay Act; entire bill H.R. 2779 Defined Contribution Plan Fee Transparency Act; provisions relating to fee disclosure H.R. 2989 - 401(k) Fair Disclosure and Pension Security Act of 2009; provisions relating to fee disclosures and investment advice H.R. 3429 - Generate Retirement Ownership Through Long-Term Holding Act of 2009; entire bill H.R. 3936 Preserve Benefits and Jobs Act of 2009; provisions relating to employer-provided pension plans and retirement savings H.R. 4213 American Worker, State, and Business Relief Act; possible inclusion of provisions relating to fee disclosure H.R. 4126 - Retirement Fairness Act of 2009; entire bill H.R. 4146 - Sensible Transparency for Retirement Plans Act of 2009; entire bill H.R. 4742 Small Businesses Add Value for Employees (SAVE) Act; entire bill S. 401 - Defined Contribution Fee Disclosure Act of 2009; entire bill S. 702 - Long-Term Care Affordability and Security Act of 2009; entire bill S. 906 - Senior Investor Protection Act; entire bill S. 1082 - The Generating Retirement Ownership Through Long-Term Holding Act; entire bill S. 1297 - Retirement Security for Life Act; entire bill S. 1661 - Senior Investment Protection Act of 2009; entire bill S. 2832 Lifetime Income Disclosure Act; entire bill Administrations Budget provisions relating to Auto IRA proposal

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

S 3590, Patient Protection and Affordable Health Care Act, provisions related to long-term care and group medical insurance. S 702, Long Term Care Affordability and Security Act, all provisions. S 697, HR 1721, Community Living Assistance Services and Supports Act, all provisions. HR 3200, S 1679, Affordable Health Choices Act of 2009, provisions related to long-term care and group medical insurance.

Client expense: $1,890,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)

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

Community Pharmacy Fairness Act of 2009 H.R. 1204 Healthy Americans Act H.R. 1321 Emergency Retiree Health Benefits Protection Act H.R. 1322 Family Leave Insurance Act of 2009 H.R. 1723 Long-Term Care Affordability and Security Act of 2009 H.R. 2096 Healthy Families Act (mandatory sick leave) H.R. 2460 The Patients Choice Act H.R. 2520 Tax Equity for Health Plan Beneficiaries Act of 2009 H.R. 2625 Health Care Reform issues affecting employer sponsored plans, employer responsibilities, accounting for part-time workers, ERISA preemption, quality, wellness provisions, financing, delivery, costs, coverage, tax policy; minimum benefits standard, pay or play requirements, public health insurance plan option, taxation of Medicare Part D subsidy, The Community Living Assistance Services and Support Program (CLASS Act), Health Savings Accounts (HSAs), Flexible Spending Arrangements (FSAs), effectives dates and transition period Patient Protection and Affordable Care Act (PPACA) H.R. 3590, Public Law No: 111-148 Prevent application of ERISA preemption to state law causes of action - H.R. 3925 Extended COBRA Continuation Protection Act of 2009 H.R. 3930 Affordable Health Care for America Act H.R. 3962 Common Sense Health Care Reform and Affordability Act H.R. 4038 American Workers, State, and Business Relief Act H.R. 4213, & substitute amendment Department of Defense Appropriations Act for Fiscal Year 2010 (House Amendment to the Senate Amendment to H.R. 3326. Public Law No: 111-118 COBRA Subsidy Program Jobs for Main Street Act House Amendment to the Senate Amendment to H.R. 2847 Temporary Extension Act of 2010 H.R. 4691 Public Law No: 111-144, COBRA Subsidy Program extension Health Care and Education Affordability Reconciliation Act of 2010 H.R. 4872: package of modifications to H.R. 3590 Fiscal Year 2011 Budget health plan proposals Presidents Proposal on Health Care Reform summary (2/22) Healthy Americans Act - S. 391 Long-Term Care Affordability and Security Act of 2009 S. 702 The Patients Choice Act S. 1099 Healthy Families Act (mandatory sick leave) S. 1152 Tax Equity for Health Plan Beneficiaries Act of 2009 S. 1153 Confidence in Long-Term Care Insurance Act S. 1177 Patient Centered Outcomes Research Act S. 1213 Health Care Reform issues affecting employer sponsored plans, employer responsibilities, part-time, seasonal, and short-term worker issues, ERISA preemption, quality, wellness provisions, financing, delivery, costs, coverage, tax policy; minimum benefits standard, pay or play requirements, public health insurance plan option, taxation of Medicare Part D subsidy, The Community Living Assistance Services and Support Program (CLASS Act), Health Savings Accounts (HSAs), Flexible Spending Arrangements (FSAs), effectives dates and transition period The COBRA Subsidy Extension and Enhancement Act S. 2730 Patient Protection and Affordable Care Act (PPACA) H.R. 3590, Law No: 111-148 American Workers, State, and Business Relief Act H.R. 4213 & substitute amendment Temporary Extension Act of 2010 H.R. 4691 Public Law No: 111-144 COBRA Subsidy Program extension Health Care and Education Affordability Reconciliation Act of 2010 H.R. 4872: package of modifications to H.R. 3590 Continuing Extension Act H.R. 4851: short-term COBRA extension Hiring Incentives to Restore Employment Act (HIRE) COBRA subsidy extension Fiscal Year 2011 Budget health plan proposals Presidents Proposal on Health Care Reform summary (2/22) Regulatory communication with covered federal officials on legislative issues DOL/Employee Benefits Security Administration, EBSA) health care reform legislation and implementation, ERISA preemption DOL/Employee Benefits Security Administration (EBSA)/Office of Management and Budget (OMB) - proposed rule on application of ERISA to state/local health reform efforts DOL /EBSA)/IRS/Treasury/HHS - Genetic Information Nondiscrimination Act (GINA) of 2008 Treasury/IRS/DOL/EBSA COBRA premium subsidy assistance extension American Recovery and Reinvestment Act of 2009 (ARRA) included in the Department of Defense Appropriations Act of 2010 DOL/HHS-CMS/Treasury/IRS Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 Interim Final Regulations Commerce, Office of the Secretary taxation of Medicare Part D subsidy White House/Executive Office of the President: OMB & NEC Stand for Quality Coalition health care reform White House/Executive Office of the President - health care reform Office of the Vice President health care reform: taxation of Medicare Part D Subsidy

Client expense: $258,735 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of the Vice President of the United States, Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of, White House Office

See attachment.. RET First Quarter Report 2010 H.R. 519 The Elder Caregiver Support and Information Enhancement Act of 2009. Issue: LTC additional appropriations for LTC Information clearinghouse. H.R. 1961 - Savings for American Families Future Act Issue: savers' credit H.R. 1984 - 401(k) Fair Disclosure for Retirement Security Act of 2009. Issue: Retirement plan fee disclosure. H.R. 1988 Conflicted Investment Advice Prohibition Act of 2009. Issue: Investment Advice. H.R. 2021 Savings Recovery Act of 2009. Issue: Savers credit. H.R. 2733/S. 1389 Fixed Indexed Annuities and Insurance Products Classification Act of 2009. Issue: Clarify exemption for fixed indexed annuities. H.R. 2748 Retirement Security Needs Lifetime Pay Act of 2009. Issue: Tax Incentive for Annuities. H.R. 2779 Defined Contribution Plan Fee Transparency Act of 2009. Issue: 401(k) Plan Fee Disclosure. H.R. 2792 Retirement Savings Transparency Act. Issue: Plan fee disclosure. H.R. 2989 401 (K) Fair Disclosure and Pension Security Act of 2009. Issue: Retirement Plan Fee Disclosure H.R. 3590-The Patient Protection and Affordable Care Act. Issue: Long Term Care financing within heath reform and Medicare tax on nonqualified annuity income. H. R. 4126 Retirement Fairness Act. Issue: Modification of 401(k) Plan Rules. H. R. 4173 Wall Street Reform and Consumer Protection Act. Issue: Exclusion of retirement plans from CFPA and suitability in insurance product sales to seniors and sales of annuities. H.R. 4626 - Health Insurance Industry Fair Competition Act. Issue: Amends the McCarran-Ferguson Act to apply to the business of health insurance. H.R. 4742 - SAVE Act. Issue: simplifies SIMPLE IRAs and provides for voluntary Auto IRAs. H.R. 4872 Health Care and Education Reconciliation Act of 2010. Issue: LTC financing within health reform and unearned income tax. S. 401 - Defined Contribution Fee Disclosure Act Issue: 401(k) fee disclosure S. 697/ HR 1721 Community Living Assistance Services and Supports Act. Issue: reform of LTC financing. S 702/ HR 2096 - Long Term Care Affordability and Security Act of 2009. Issue: allows long term care insurance to be offered in employer sponsored cafeteria plans and FSA. S. 1177 - Confidence in Long Term Care Insurance Act of 2009. Issue: Consumer protection for long term care. S. 1226: Long Term Care Insurance Integrity Act of 2009. Issue: Long Term Care. S. 1297 - Retirement Security for Life Act. Issue: Tax Incentive for Non Qualified Annuities. S. 1636 Long Term Care Insurance Consumer Right-To-Know Act of 2009. Issue: Long Term Care consumer protections. S. 1661/S. 906/H.R. 3551 Senior Investment Protection Act of 2009. Issue: Suitability in insurance product sales to seniors and the sale of annuities. S. 2832 Lifetime Income Disclosure Act. Issue: Annuity illustration on benefit statements. S._____ - Restoring American Financial Stability Act. Issue: incorporates Senior Investor Protection Act and provides for employer benefit plan carve out from CFPB.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of the Comptroller of the Currency (OCC), SENATE

H.R. 3590: the Patient Protection and Affordable Care Act H.R. 4872: the Health Care and Education Reconciliation Act of 2010 S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the trageting of the enforcement of requirements with respect to such facilities. S.1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure ofr delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older American with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuing adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute edler abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title of certain non-instutional full-benefit dual eligible individuals. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1679: An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experiences health care professionals. S.1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. H.R. 2: To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. S. 795: A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.631: A bill to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 458: A bill to amend the False Claims Act. H.R. 2043: To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students, and for other purposes. H.R. 1642: To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 1494: To ensure that a private for-profit nursing home affected by a major disaster receives the same rreimbursement as a public nursing home affected by a major disaster. H.R. 448: To protect seniors in the United States from elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes. H.R. 3191: 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. S. 386: A bill to improve enforcement of mortgage fraud, securities fraud, financial institutional fraud, and other frauds related to federal assistance and relief programs, for the recovery of funds lost to these frauds, and for other purposes.

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE