Generics First Act of 2009

HR 452 - Medicare Decisions Accountability Act of 2011 S 319 - Pharmaceutical Market Access and Drug Safety Act of 2011 Gene Therapy Personalized Medicine H.R.2245 Preserving Access to Life-Saving Medications Act of 2011 S.296 Preserving Access to Life-Saving Medications Act S.1206 Medicare Drug Savings Act of 2011 H.R.2190 Medicare Drug Savings Act of 2011 Section 9008 of Patient Protection and Affordable Care Act Prescription Drug User Fee Act (PDUFA) H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Public Health Service Act Dextromethorphan - Age Restrictions - Controlling bulk shipments Pseudoephedrine - Promote e-tracking; oppose Rx legislation FSA/HSA - Support reinstating coverage of OTC products Enhance supply and shipping parameters for beta-Propiolactone Support incentives for development of new, innovative antibiotics (former GAIN Act) MDUFA

Client expense: $1,902,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR)

HR 452 - Medicare Decisions Accountability Act of 2011 S 319 - Pharmaceutical Market Access and Drug Safety Act of 2011 Gene Therapy Personalized Medicine H.R.2245 Preserving Access to Life-Saving Medications Act of 2011 S.296 Preserving Access to Life-Saving Medications Act S.1206 Medicare Drug Savings Act of 2011 H.R.2190 Medicare Drug Savings Act of 2011 Section 9008 of Patient Protection and Affordable Care Act Prescription Drug User Fee Act (PDUFA) H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Public Health Service Act Dextromethorphan - Age Restrictions - Controlling bulk shipments Pseudoephedrine - Promote e-tracking; oppose Rx legislation FSA/HSA - Support reinstating coverage of OTC products Enhance supply and shipping parameters for beta-Propiolactone Support incentives for development of new, innovative antibiotics (former GAIN Act) MDUFA

Client expense: $1,129,000 · Firm income: Not reported

HR 452 - Medicare Decisions Accountability Act of 2011 S 319 - Pharmaceutical Market Access and Drug Safety Act of 2011 Gene Therapy Personalized Medicine H.R.2245 Preserving Access to Life-Saving Medications Act of 2011 S.296 Preserving Access to Life-Saving Medications Act S.1206 Medicare Drug Savings Act of 2011 H.R.2190 Medicare Drug Savings Act of 2011 Section 9008 of Patient Protection and Affordable Care Act Prescription Drug User Fee Act (PDUFA) H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Public Health Service Act Dextromethorphan - Age Restrictions - Controlling bulk shipments Pseudoephedrine - Promote e-tracking; oppose Rx legislation FSA/HSA - Support reinstating coverage of OTC products Enhance supply and shipping parameters for beta-Propiolactone Support incentives for development of new, innovative antibiotics (former GAIN Act) MDUFA

Client expense: $1,631,812 · Firm income: Not reported

HR 452 - Medicare Decisions Accountability Act of 2011 S 319 - Pharmaceutical Market Access and Drug Safety Act of 2011 Gene Therapy Personalized Medicine H.R.2245 Preserving Access to Life-Saving Medications Act of 2011 S.296 Preserving Access to Life-Saving Medications Act S.1206 Medicare Drug Savings Act of 2011 H.R.2190 Medicare Drug Savings Act of 2011 Section 9008 of Patient Protection and Affordable Care Act Prescription Drug User Fee Act (PDUFA) H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Public Health Service Act Dextromethorphan - Age Restrictions - Controlling bulk shipments Pseudoephedrine - Promote e-tracking; oppose Rx legislation FSA/HSA - Support reinstating coverage of OTC products Enhance supply and shipping parameters for beta-Propiolactone Support incentives for development of new, innovative antibiotics (former GAIN Act) MDUFA

Client expense: $1,918,136 · Firm income: Not reported

HR 452 - Medicare Decisions Accountability Act of 2011 S 319 - Pharmaceutical Market Access and Drug Safety Act of 2011 Gene Therapy Personalized Medicine H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Public Health Service Act Dextromethorphan - Age Restrictions - Controlling bulk shipments Pseudoephedrine - Promote e-tracking; oppose Rx legislation FSA/HSA - Support reinstating coverage of OTC products Enhance supply and shipping parameters for beta-Propiolactone Support incentives for development of new, innovative antibiotics (former GAIN Act) MDUFA

Client expense: $1,650,000 · Firm income: Not reported

H.R.3200 America's Affordable Health Choices Act of 2009 S.1796 America's Healthy Future Act of 2009 H.R.3962 Affordable Health Care for America Act H.R.3590 Patient Protection and Affordable Care Act H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy PDUFA

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

HR 1 ARRA (increase in FMAP and moratorium on Medicaid Regulations). HR 2 SCHIP, HR 904/S 547 (Medicaid drug rebates). HR 684/S 330 (establish Government PDPs). S 266 (government run negotiation of drug prices in Medicare.) S 75 (to promote generic drugs in Medicare). S 677 (means-test Part B premiums). S 1832 (to regulate Part D plan prices). S 960 (Medicare Buy-In for age 55-64). HR 3961 ("Doc Fix"). S. 2128 (MM Fraud & Abuse) S 1776 (SGR).

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

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

H.R.3200 America's Affordable Health Choices Act of 2009 S.1796 America's Healthy Future Act of 2009 H.R.3962 Affordable Health Care for America Act H.R.3590 Patient Protection and Affordable Care Act H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy PDUFA

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

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S.960 (Medicare Buy in); HR 3961 ("Doc Fix"); S. 2128 (MM Fraud & Abuse); S. 1776 (SGR). HR 3590/HR 48

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

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

H.R.3200 America's Affordable Health Choices Act of 2009 S.1796 America's Healthy Future Act of 2009 H.R.3962 Affordable Health Care for America Act H.R.3590 Patient Protection and Affordable Care Act H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy PDUFA

Client expense: $1,842,000 · Firm income: Not reported

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S.960 (Medicare Buy in); HR 3961 ("Doc Fix"); S. 2128 (MM Fraud & Abuse); S. 1776 (SGR). HR 3590/HR 48

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

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

H.R.3200 America's Affordable Health Choices Act of 2009 S.1796 America's Healthy Future Act of 2009 H.R.3962 Affordable Health Care for America Act H.R.3590 Patient Protection and Affordable Care Act H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy PDUFA

Client expense: $1,616,000 · Firm income: Not reported

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S.960 (Medicare Buy in); HR 3961 ("Doc Fix"); S. 2128 (MM Fraud & Abuse); S. 1776 (SGR).

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

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

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

H.R.3200 America's Affordable Health Choices Act of 2009 S.1796 America's Healthy Future Act of 2009 H.R.3962 Affordable Health Care for America Act H.R.3590 Patient Protection and Affordable Care Act H.R.4872 Health Care and Education Reconciliation Act of 2010 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 H.R.759 Food and Drug Administration Globalization Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy PDUFA

Client expense: $2,040,000 · Firm income: Not reported

Medicare Advantage, Part D, special needs plans, medicare cost plans, medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3962, America's Affordable Health Choices Act. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3590, An act entitled The Patient Protection and Affordable Care Act. Changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding - HR 4872, Health Care and Education Reconciliation Act of 2010. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re this issue; HR 3590, An act entitled The Patient Protection and Affordable Care Act. *Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. *Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. *Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, America's Affordable Health Choices Act. *Medicare physician payments - HR 3961, Medicare Physician Payment Reform Act of 2009; HR 4691, Temporary Extension Act of 2010; HR 4851, Continuing Extension Act of 2010; S 3153, Continuing Extension Act of 2010. *MA special needs plans, cost plans, Medicare physician payments, Medicaid FMAP - HR 4213, American Workers, State, and Business Relief Act of 2010. *Medicaid FMAP extension - HR 4263, State Medicaid Assistance Extension Act of 2009; S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months. *Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. *Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. *Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. *Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. *Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. *Implementation of Medicare payment policies - HR 2718, To amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy.; S 1380, A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. *Medicare Advantage special needs plans - HR 2758, To amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes; S 1307, A bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes. *Home and community-based services under Medicaid - HR 2688, To amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program, and for other purposes. *Part D enrollment - HR 3152, To amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs. *Part D exceptions process, HR 3418, To amend part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs. *Part B premiums - HR 3631, To amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010. *Government-operated Part D plan, dual eligibles - S 1634, A bill to amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs. *Guaranteed-issue MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. *Medicaid FMAP - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes. *Medicare physician payments - S 1776, A bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform - S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. *HHS Secretary's role in negotiating Part D drug prices - HR 4752, Medicare Prescription Drug Price Negotiation Act of 2010. *Medicare Part D formulary changes - HR 4917, To amend part D of title XVIII of the Social Security Act to prohibit mid-year changes in the formularies of Medicare Part D plans. *Medicare physician payment, pay-as-you-go budget rules - HJRes 45, Increasing the statutory limit on the public debt. *Medicaid QI Program funding - S 2949, Emergency Aid to American Survivors of the Haiti Earthquake Act.

HR 1 ARRA (increase in FMAP and moratorium on Medicaid Regulations). HR 2 SCHIP, HR 904/S 547 (Medicaid drug rebates). HR 684/S 330 (establish Government PDPs). S 266 (government run negotiation of drug prices in Medicare.) S 75 (to promote generic drugs in Medicare). S 677 (means-test Part B premiums). S 1832 (to regulate Part D plan prices). S 960 (Medicare Buy-In for age 55-64). HR 3961 ("Doc Fix"). S. 2128 (MM Fraud & Abuse) S 1776 (SGR).

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

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

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Part C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio for insurance premiums, inclusion of patient-centered quality reporting requirements for providers, creating new claims reviews processes and provider certification, requiring reporting by practitioners of gifts received from pharmaceutical and medical device manufacturers. Medicare/Commission. P.L. 111-148, P.L. 111-152, H.R. 4872: creating an independent commission authorized to establish Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330, H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. P.L. 111-148, P.L. 111-152, H.R. 4872, S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 27: relating to provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 43, S. 46: repealing or extending exceptions to outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authorizing coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894, S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1407, S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700, H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458, S. 565: provision related to continued coverage for immunosuppressive drugs furnished to beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765, S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574, S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 1131, H.R. 2560: provisions establishing pilot care coordination programs. Medicaid/Home and Community-based Long Term Care. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid. P.L. 110-275, P.L. 108-173: implementation of regulations and guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and appeals processes under Medicare Parts C and D.

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 S. 1630 - Affordable Access to Prescription Medicine Act of 2009 S. 1679 - Affordable Heath Choices Act of 2009 Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $6,200,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 S. 1630 - Affordable Access to Prescription Medicine Act of 2009 S. 1679 - Affordable Heath Choices Act of 2009 Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $5,490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 684, The Medicare Prescription Drug Savings and Choice Act of 2009 S. 75, Generics First Act of 2009 (Part D) HR 574, Medicare Home Infusion Therapy Coverage Act of 2009 Medicare Prescription Drug Benefit Implementation - retain Medicaid Rebates - retain the general issues section Medicare Coverage Average Manufacturer Price Regulation

Client expense: $5,860,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

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

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 S. 1630 - Affordable Access to Prescription Medicine Act of 2009 S. 1679 - Affordable Heath Choices Act of 2009 Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $5,590,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

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

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 S. 1630 - Affordable Access to Prescription Medicine Act of 2009 S. 1679 - Affordable Heath Choices Act of 2009 Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $5,590,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 1 ARRA (increase in FMAP and moratorium on Medicaid Regulations). HR 2 SCHIP, HR 904/S 547 (Medicaid drug rebates). HR 684/S 330 (establish Government PDPs). S 266 (government run negotiation of drug prices in Medicare.) S 75 (to promote generic drugs in Medicare). S 677 (means-test Part B premiums). S 1832 (to regulate Part D plan prices). S 960 (Medicare Buy-In for age 55-64). HR 3961 ("Doc Fix"). S. 2128 (MM Fraud & Abuse) S 1776 (SGR).

Client expense: $802,573 · Firm income: Not reported

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

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

Vaccines for Children Program Vaccines for Adults Coverage Provide Medicare Part B Coverage for Vaccines Currenlty Under Part D Medicaid Coverage of Vaccines HR 3200 America's Affordable Health Choices Act of 2009 HR 2502 Comparative Effectiveness Research Act of 2009 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 S 2467 - Vaccine shortage preparedness Act of 2008 S 3678 - /PL 109-417 All pandemic and all-hazards act - Section 317 program issues HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy Direct to Consumer Advertising Drug Safety Legislation Global Hypertension

Client expense: $1,570,000 · Firm income: Not reported

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. H.R. 3590, H.R. 3962, H.R. 3200, S. 1679: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Part C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio for insurance premiums, inclusion of patient-centered quality reporting requirements for providers, creating new claims reviews processes and provider certification, requiring reporting by practitioners of gifts received from pharmaceutical and medical device manufacturers. Medicare/Commission. S. 1110 and S. 1380: authorizing an enhanced MedPAC as an executive branch commission with authority to implement Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43/S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authoring coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407/S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700/H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458/S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765/S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574/S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program.

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 S. 1630 - Affordable Access to Prescription Medicine Act of 2009 S. 1679 - Affordable Heath Choices Act of 2009 Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $5,420,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 684, The Medicare Prescription Drug Savings and Choice Act of 2009 S. 75, Generics First Act of 2009 (Part D) HR 574, Medicare Home Infusion Therapy Coverage Act of 2009 Medicare Prescription Drug Benefit Implementation - retain Medicaid Rebates - retain the general issues section Medicare Coverage Average Manufacturer Price Regulation

Client expense: $5,340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

Medicare Advantage program - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re this issue. Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. Implementation of Medicare payment policies - HR 2718, To amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy.; S 1380, A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. Medicare Advantage special needs plans - HR 2758, To amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes; S 1307, A bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes. Home and community-based services under Medicaid - HR 2688, To amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program, and for other purposes. Part D enrollment - HR 3152, To amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs. Part D exceptions process, HR 3418, To amend part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs. Part B premiums - HR 3631, To amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010. Government-operated Part D plan, dual eligibles - S 1634, A bill to amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs. Guaranteed-isse MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy.

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

Vaccines for Children Program Vaccines for Adults Coverage Provide Medicare Part B Coverage for Vaccines Currenlty Under Part D Medicaid Coverage of Vaccines HR 3200 America's Affordable Health Choices Act of 2009 HR 2502 Comparative Effectiveness Research Act of 2009 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 S 2467 - Vaccine shortage preparedness Act of 2008 S 3678 - /PL 109-417 All pandemic and all-hazards act - Section 317 program issues HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act S.1232 - Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes S 525 - Pharmaceutical Market Access and Drug Safety Act of 2009 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy Direct to Consumer Advertising Drug Safety Legislation Global Hypertension

Client expense: $1,420,000 · Firm income: Not reported

S. 75 Generics First Act of 2009 S. 301 Physician Payments Sunshine Act of 2009 H.R. 1894/S. 769 Medicare Fracture Prevention and Osteoporosis Testing Act of 2009

Client expense: $1,131,806 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Intl Trade Administration (ITA), Justice, Dept of (DOJ), Natl Security Council (NSC), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE), U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. H.R. 3200, S. 1679, Senate Finance Committee Mark of Americas Healthy Futures Act: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Part D, reducing the Part A deductible, establishing an out-of-pocket maximum under Medicare, establishing a voluntary comprehensive benefit option under Medicare, authorizing a Medicare-operated Part D drug plan, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Parts D and C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services, integrating mental health services in primary care and community settings, eliminating the 45 percent funding trigger provision, establishing a Medicare Commission, providing Medicaid coverage for home and community-based services, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio and clarifying the Medicare Secondary Payer statute. Medicare/Commission. S. 1110 and S. 1380: authorizing an enhanced MedPAC as an executive branch commission with authority to implement Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43/S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authoring coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407/S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700/H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458/S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765/S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574/S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program. Medicaid/Home and Community-based Long Term Care. S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid.

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S. 960 ("Buy-In" to Medicare, age 55-64)

Client expense: $580,743 · Firm income: Not reported

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

HR 684, The Medicare Prescription Drug Savings and Choice Act of 2009 S. 75, Generics First Act of 2009 (Part D) HR 574, Medicare Home Infusion Therapy Coverage Act of 2009 Medicare Prescription Drug Benefit Implementation - retain Medicaid Rebates - retain the general issues section Medicare Coverage Average Manufacturer Price Regulation

Client expense: $5,340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $5,580,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

S. 75 Generics First Act of 2009 S. 301 Physician Payments Sunshine Act of 2009 H.R. 1894/S. 769 Medicare Fracture Prevention and Osteoporosis Testing Act of 2009

Client expense: $1,131,806 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Intl Trade Administration (ITA), Justice, Dept of (DOJ), Natl Security Council (NSC), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE), U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

S. 75 Generics First Act of 2009 S. 301 Physician Payments Sunshine Act of 2009 H.R. 1894/S. 769 Medicare Fracture Prevention and Osteoporosis Testing Act of 2009

Client expense: $1,275,841 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Intl Trade Administration (ITA), Justice, Dept of (DOJ), Natl Security Council (NSC), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE), U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

Vaccines for Children Program Vaccines for Adults Coverage Provide Medicare Part B Coverage for Vaccines Currenlty Under Part D Medicaid Coverage of Vaccines HR 3200 America's Affordable Health Choices Act of 2009 S 75 - Generics First Act 2009 S 301 - Physician Payments Sunshine Act of 2009 HR 276 - Proper Disposal of Unused Pharmaceuticals HR 2502 Comparative Effectiveness Research Act of 2009 S1213 Patient-Centered Outcomes Research Act of 2009 HR 4702, HR 4990 - A bill to amend title XIX of the Social Security Act to include all public clinics for the distribution of pediatric vaccines under the Medicaid program. HR 4705 HR 4993, S 2466 - Vaccines for the uninsured Adult Act of 2008 S 2467 - Vaccine shortage preparedness Act of 2008 S 3678 - /PL 109-417 All pandemic and all-hazards act - Section 317 program issues HR 1259 Dextromethorphan Distribution Act of 2009 S 1383 Dextromethorphan Abuse Reduction Act of 2009 S 256 Combat Methamphetamine Enhancement Act of 2009 HR 2923 Combat Methamphetamine Enhancement Act of 2009 HR 1038, S623 - Access to Life-Saving Medicine Act HR 1548 Pathway for Biosimilars Act HR 1427 - Promoting Innovation and Access to Life-Saving Medicine Act S 726 - Promoting Innovation and Access to Life-Saving Medicine Act HR 1548 - To amend the Public Health Service Act to establish a pathway for the licensure of biosimilar biological products, and for other purposes 21st Century Cancer Bill Personalized Medicine Public Health Service Act Drug Importation Gene Therapy Direct to Consumer Advertising Drug Safety Legislation Global Hypertension

Client expense: $1,808,536 · Firm income: Not reported

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

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

Comprehensive Health Care Reform. House Tri-Committee Discussion Draft, Senate Health, Education, Labor and Pensions Committee draft bill, Senate Finance Committee Description of Policy Options (No bill numbers as of this date): provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, reducing the Part A deductible, establishing an out-of-pocket maximum under Medicare, establishing a voluntary comprehensive benefit option under Medicare, authorizing a Medicare-operated Part D drug plan, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improvement of the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services, elimination of the 45 percent funding trigger provision, providing Medicaid coverage for home and community-based services, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio and clarifying the Medicare Secondary Payer statute. Medicare/Prescription Drug Plan. S.330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Means Testing. S. Amdt. 805 (to S. Con. Res. 13), S. 677: requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Part D. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43/S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authoring coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407/S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700/H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458/S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765/S. 701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574/S. 254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Comparative Effectiveness. S. Amdt. 793 (to S. Con. Res. 13): prohibiting research information comparing the effectiveness of different treatments to deny coverage of products or services under federal health care programs including Medicare. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program. Medicare/Medicaid Reimbursement. S. Amdt. 799 (to S. Con. Res. 13): addressing the systemic inequities of Medicare and Medicaid reimbursement in rural areas. Medicaid/Home and Community-based Long Term Care. S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid.

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S. 960 Medicare "Buy-In"

Client expense: $631,846 · Firm income: Not reported

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