Caring for an Aging America Act of 2009

Legislation and issues relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); H.R. 2043/S. 497 - Nurse Education, Expansion, and Development Act; H.R. 2350/S. 1174 - Preserving Patient Access to Primary Care Act; H.R. 3098/S. 750 - Caring for an Aging America Act; nursing provisions in potential job creation legislation.

Client expense: Not reported · Firm income: $7,800

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

Aging, Health Care Workforce and Medicare, including the Patient Protection and Affordable Care Act, H.R. 3962, S. 750, S. 1340 and H.R. 2244 and funding for health care programs in Labor/HHS bill

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

1. S. 750, the "Caring for an Aging America Act of 2009," a bill to provide for the establishment of a new geriatric and gerontology loan repayment program. Support all provisions. 2. S. 245/H.R. 468, the "Retooling the Health Care Workforce for an Aging American Act of 2009". This bill addresses the current and future shortage of health care personnel who are trained to care for older adults. Support all provisions. 3. S. 682, the "Mental Health on Campus Improvement Act," to amend the Public Health Service Act to improve mental and behavioral services on college campuses. Support all provisions. 4. S. 697, the "Community Living Assistance Supports and Services Act (CLASS Act)," to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment. Support all provisions. Support inclusion of provisions of this bill in healht care reform legislation (H.R. 3590). 5. H.R. 1457, the "Geriatrics Loan Forgiveness Act of 2009," to amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, which provides up to $50,000 to repay student loans in exchange for working for two years in a high-need Health Professional Shortage Area. Support all provisions. 6. Discussed with House and Senate staff the need to include older adults in clinical trials. 7. Support comparative effectiveness research focused specifically on treatments for older adults and mental illness. 8. Support programs to reverse the declining numbers of geriatric specialists. 9. Support legislation to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. 10. Support H.R. 1932/S. 999, the "Child Health Care Crisis Relief Act," to address the national shortage of children's mental health professionals, including school-based professionals, by encouraging more individuals to enter these critical fields. 11. S. 678, "Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009". Support all provisions, but especially those that strengthen protections for those in the criminal and juvenile justices systems with needs related to mental health and substance abuse. 12. Support H.R. 2901, "Healthy Transitions Act," to provide access to knowledge, skills, and supports that are necessary for a successful transition to adulthood for young adults with mental health disorders. The bill would provide technical and monetary assistance to states as they implement plans to develop a coordinated service delivery system in order to maximize continuity of care and access to services. The bill would also establish planning and implementation grants to assist peer support programs and programs promoting independent living, life skills, employment, and education. 13. Support H.R. 1193, the "Federal Response to Eliminate Easting Disorders Act" (H.R. 1193/S. 3260), to create Centers of Excellence dedicated to research collaboration, create a Center of Epidemiology to study the prevalence, economic impact and related morbidity and mortality rates of eating disorders, provide for evidence-based standards of care, establish education and prevention grant programs for training of health professionals and schools at all levels, provide public service announcements, and enhance access to care for those who suffer from eating disorders. 14. Support H.R. 2531, the "Mental Health in Schools Act of 2009," to authorize competitive grants to local school districts to assist them in early mental health interventions and referrals for treatment, to provide supports for students and their families, and to allow for staff training to be culturally and linguistically appropriate. 15. H. R. 3191 and S. 3698, the "Positive Aging Act," to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. Support all provisions. 16. Support S. 1857 and H. R. 4204, to establish national centers of excellence for the treatment of depression and bipolar disorders. 17. Support S. 2928, to include direct care workers as a priority for the National Health Care Workforce Commission. 18. Support efforts to strengthen existing Title VII geriatric health professions education programs. 19. Support H.R. 5466, the "SAMHSA Modernization Act of 2010," to reauthorize programs administered by the Substance Abuse and Mental Health Services Administration. Support provisions to improve the accessibility and quality of mental heatlh services for the elderly. 20. Support H.R. 5040, the "Health Information Technology Extension for Behavioral Health Sciences Act of 2010," to extend the meaningful use incentives established through the American Recovery and Reinvestment Act to mental health and substance abuse providers and facilities, including psychiatric hospitals, community mental health centers, mental health treatment facilities, clinical psychologists and social workers.

Client expense: $20,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Aging, Health Care Workforce and Medicare, including H.R. 3590, H.R. 3962, S. 750, S. 1340 and H.R. 2244 and funding for health care programs in Labor/HHS bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. S. 750, the "Caring for an Aging America Act of 2009," a bill to provide for the establishment of a new geriatric and gerontology loan repayment program. Support all provisions. 2. S. 245/H.R. 468, the "Retooling the Health Care Workforce for an Aging American Act of 2009". This bill addresses the current and future shortage of health care personnel who are trained to care for older adults. Support all provisions. 3. S. 682, the "Mental Health on Campus Improvement Act," to amend the Public Health Service Act to improve mental and behavioral services on college campuses. Support all provisions. 4. S. 697, the "Community Living Assistance Supports and Services Act (CLASS Act)," to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment. Support all provisions. Support inclusion of provisions of this bill in healht care reform legislation (H.R. 3590). 5. H.R. 1457, the "Geriatrics Loan Forgiveness Act of 2009," to amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, which provides up to $50,000 to repay student loans in exchange for working for two years in a high-need Health Professional Shortage Area. Support all provisions. 6. Discussed with House and Senate staff the need to include older adults in clinical trials. 7. Support comparative effectiveness research focused specifically on treatments for older adults and mental illness. 8. Support programs to reverse the declining numbers of geriatric specialists. 9. Support legislation to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. 10. Support H.R. 1932/S. 999, the "Child Health Care Crisis Relief Act," to address the national shortage of children's mental health professionals, including school-based professionals, by encouraging more individuals to enter these critical fields. 11. S. 678, "Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009". Support all provisions, but especially those that strengthen protections for those in the criminal and juvenile justices systems with needs related to mental health and substance abuse. 12. Support H.R. 2901, "Healthy Transitions Act," to provide access to knowledge, skills, and supports that are necessary for a successful transition to adulthood for young adults with mental health disorders. The bill would provide technical and monetary assistance to states as they implement plans to develop a coordinated service delivery system in order to maximize continuity of care and access to services. The bill would also establish planning and implementation grants to assist peer support programs and programs promoting independent living, life skills, employment, and education. 13. Support H.R. 1193, the "Federal Response to Eliminate Easting Disorders Act" (H.R. 1193/S. 3260), to create Centers of Excellence dedicated to research collaboration, create a Center of Epidemiology to study the prevalence, economic impact and related morbidity and mortality rates of eating disorders, provide for evidence-based standards of care, establish education and prevention grant programs for training of health professionals and schools at all levels, provide public service announcements, and enhance access to care for those who suffer from eating disorders. 14. Support H.R. 2531, the "Mental Health in Schools Act of 2009," to authorize competitive grants to local school districts to assist them in early mental health interventions and referrals for treatment, to provide supports for students and their families, and to allow for staff training to be culturally and linguistically appropriate. 15. H. R. 3191, the "Positive Aging Act," to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. Support all provisions. 16. Support S. 1857 and H. R. 4204, to establish national centers of excellence for the treatment of depression and bipolar disorders. 17. Support S. 2928, to include direct care workers as a priority for the National Health Care Workforce Commission. 18. Support efforts to strengthen existing Title VII geriatric health professions education programs. 19. Support H.R. 5466, the "SAMHSA Modernization Act of 2010," to reauthorize programs administered by the Substance Abuse and Mental Health Services Administration. Support provisions to improve the accessibility and quality of mental heatlh services for the elderly. 20. Support H.R. 5040, the "Health Information Technology Extension for Behavioral Health Sciences Act of 2010," to extend the meaningful use incentives established through the American Recovery and Reinvestment Act to mental health and substance abuse providers and facilities, including psychiatric hospitals, community mental health centers, mental health treatment facilities, clinical psychologists and social workers.

Client expense: $20,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H Res 1003 - Expressing support for the designation of January 10, 2010, through January 16, 2010, as National Influenza Vaccination Week HR 2891 - Access to Frontline Health Care Act of 2009 Under Line 17: We would like to include the Agency for Healthcare Research and Quality (AHRQ) S 750 - Caring for an Aging America Act HR 1259 - Dextromethorphan Distribution Act of 2009 S 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research. HR 2345 - Amends the Fair Credit Reporting Act to provide for an exclusion from Red Flag Guidelines for health care practices S 1213 - Patient-Centered Outcomes Research Act of 2009 HR 756/S 660 - National Pain Care Policy Act of 2009 HR 4872/ Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 [Sections on Medicare Part D Changes; CMS/IRS data match to identify fraudulent providers; funding to fight fraud, waste and abuse; 90-day period of enhanced oversight for initial claims of DME suppliers; excise tax on medical device manufacturers; and drugs purchased by covered entities.] HR 3962 - Affordable Health Care for America Act [Sections on: wellness program grants; administrative simplification; ensuring adequacy of provider networks; essential benefits package defined; requiring information transparency and plan disclosure; state prohibitions on discrimination against health care providers; protection of physician prescriber information; nondiscrimination on abortion and respect for rights of conscience; study and report on methods to increase electronic health record (EHR) use by small health care providers; contracts for the offering of exchange-participating health benefits plans; payment rates for items and services; modernized payment initiatives and delivery system reforms; provider participation under the public health insurance option; limitations on health care related expenditures including distributions for medicine qualified only if for prescribed drugs or insulin; excise tax on medical devices; permitting physician assistants to order post-hospital extended care services and to provide for recognition of attending physician assistants as attending physicians to serve hospice patients; resource-based feedback program for physicians in Medicare; modifications to the physician quality reporting initiative; home infusion therapy report to Congress; durable medical equipment (DME) program improvements; MedPAC study and report on bone mass measurement; payment for biosimilar biological products; study and report on DME competitive bidding process; reducing potentially preventable hospital readmissions; post-acute care services payment reform plan and bundling pilot program; Institute of Medicine study on geographic variation in health care spending and promoting high-value health care; implementation, and Congressional review, of proposal to revise Medicare payments to promote high-value health care; phase-in of payment based on fee-for-service costs; quality bonus payments for Medicare Advantage plans; improvements to Medicare Part D including elimination of coverage gap; discounts for certain Part D drugs in original coverage gap; repeal of provision relating to submission of claims by pharmacies located in or contracting with long-term care facilities; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under Part D; no mid-year formulary changes permitted; negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries; accurate dispensing in long-term care facilities and free generic fill; elimination of part D cost-sharing for certain non-institutionalized full-benefit dual-eligible individuals; intelligent assignment in enrollment; demonstration to promote access for Medicare beneficiaries with limited English proficiency by providing reimbursement for culturally and linguistically appropriate services; accountable care organization pilot program; medical home pilot program; coverage and waiver of cost-sharing for preventive services; expanding access to vaccines; expansion of Medicare-covered preventive services at Federally Qualified Health Centers; independence at home demonstration program; recognition of certified Diabetes Educators as certified providers for purposes of Medicare Diabetes outpatients self-management training services; comparative effectiveness research; establishment of national priorities for quality improvement; development of new quality measures; GAO evaluation of data collection process for quality measurements; multi-stakeholder pre-rulemaking input into selection of quality measures; application of quality measures; reports on financial relationships between manufacturers and distributors of covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid, or CHIP and physicians and other health care entities and between physicians and other health care entities; requirement for public reporting by hospitals and ambulatory surgical centers on health care-associated infections; pharmacy benefit managers transparency requirements; increased funding and flexibility to fight fraud and abuse; enhanced penalties for false statements on provider or supplier enrollment applications; enhanced penalties for submission of false statements material to a false claim; enhanced penalties for delaying inspections; enhanced hospice program safeguards; enhanced penalties for individuals excluded from program participation; enhanced penalties for obstruction of program audits; exclusion of certain individuals and entities from participation in Medicare and State health care programs; enhanced CMS program protection authority; enhanced Medicare, Medicaid and CHIP program disclosure requirements relating to previous affiliations; require providers and suppliers to adopt programs to reduce waste, fraud and abuse; maximum period for submission of Medicare claims reduced to not more than 12 months; telehealth expansion and enhancements; physicians who order DME or home health services required to be Medicare enrolled physicians or eligible professionals; face-to-face encounter with patient required before eligibility certifications for home health services or DME; required repayments of Medicare and Medicaid overpayments; expanded application of hardship waivers for OIG exclusions to beneficiaries of any federal health care program; requiring provider and supplier payments under Medicare to be made through direct deposit or electronic funds transfer at insured depository institutions; under Medicaid and CHIP, required coverage of preventive services, tobacco cessation, medical home pilot program, inclusion of public health clinics under the vaccines for children program, accountable care organization pilot program, state option to disregard certain income in providing continued Medicaid coverage for certain individuals with extremely high prescription, payments to pharmacists (AMP), assuring adequate payment levels for services; report on Medicaid payments, health care acquired conditions, require providers and suppliers to adopt programs to reduce waste, fraud and abuse, overpayments, termination of provider participation under Medicaid and CHIP if terminated under Medicare or other State plan or Child health plan, Medicaid and CHIP exclusion from participation relating to certain ownership, control and management affiliations; requirement to report expanded set of data elements under Medicaid Management Information System to detect fraud and abuse, and extension of QI program; improved coordination and protection for dual-eligibles; assessment of Medicare cost-intensive diseases and conditions; establishment of Center for Medicare and Medicaid Innovation within CMS; frontline health providers loan repayment program; health workforce evaluation and assessment; improving accountability for approved medical residency training; other health care workforce issues; prevention and wellness; implementation of best practices in the delivery of health care; assistant Secretary for health information; expanded participation in 340B Program; improvements to 340B Program integrity; No Child Left Unimmunized Against Influenza: demonstration program using elementary and secondary schools as influenza vaccination centers; implementation of medication management services in treatment of chronic diseases; community-based collaborative care networks; Institute of Medicine conference on pain; pain research at NIH; public awareness campaign on pain management; licensure pathway for biosimilar biological products; Indian Health Care Improvement; and Medicare vaccine coverage issues (Medicare Part B vs. Part D).] HR 3590/ Public Law 111-148 - Patient Protection and Affordable Care Act [Sections on: reinsurance for early retirees; non-discrimination in health care; essential health benefits requirements; financial integrity in Exchanges; MedPAC study on adequacy of Medicare payments for health care providers serving in rural areas; coverage of comprehensive tobacco cessation services for pregnant women in Medicaid; distributions for medicine qualified only if for prescribed drug or insulin; administrative simplification; payment for biosimilar biological products; approval pathway for biosimilar biological products; patient-centered outcomes research; special rules; prohibition against discrimination on assisted suicide; presentation of prescription drug benefit and risk information; provider screening and other enrollment requirements under Medicare, Medicaid, and CHIP; enhanced Medicare and Medicaid program integrity provisions; maximum period for submission of Medicare claims reduced to not more than 12 months; physicians who order items or services required to be Medicare enrolled physicians or eligible professionals; requirement for physicians to provide documentation on referrals to programs at high risk of waste and abuse; face to face encounter with patient required before physicians may certify eligibility for home health services or durable medical equipment under Medicare; enhanced penalties; adjustments to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program; termination of provider participation under Medicaid if terminated under Medicare or other State plan; Medicaid exclusion from participation relating to certain ownership, control, and management affiliations; health information technology enrollment standards and protocols; improvements to the physician quality reporting system; hospital readmissions reduction program; community-based care transitions program; Medicare Advantage payment; demostration project to evaluate integrated care around a hospitalization; state option to provide health homes for enrollees with chronic conditions; pediatric accountable care organization demonstration project; establishment of Center for Medicare and Medicaid Innovation within CMS; Medicare shared savings program; national pilot program on payment bundling; independence at home demonstration program; establishing community health teams to support the patient-centered medical home; Medicaid coverage for the lowest income populations; elimination of exclusion of coverage of certain drugs; providing adequate pharmacy reimbursement (AMP); exemption of certain pharmacies from DMEPOS accreditation requirements; payment adjustments for home health care; Medicare coverage gap discount program; immediate reduction in coverage Medicare Part D gap in 2010; improved information for subsidy eligible individuals reassigned to prescription drug plans and MAPD plans; improving formulary requirements for prescription drug plans and MAPD plans with respect to certain categories or classes of drugs; elimination of cost sharing for certain dual eligible individuals; uniform exceptions and appeals process for prescription drug plans and MAPD plans; Office of the Inspector General studies and reports; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under part D; reducing wasteful dispensing of outpatient prescription drugs in long-term care facilities under prescription drug plans and MAPD plans; medication management (MTM) services in treatment of chronic disease; advancing research and treatment for pain care management; National Prevention, Health Promotion and Public Health Council; clinical and community preventive services; Medicare coverage of annual wellness visit providing a personalized prevention plan; removal of barriers to preventive services in Medicare; incentives for prevention of chronic diseases in Medicaid; community transformation grants; healthy aging, living well - evaluation of community-based prevention and wellness programs for Medicare beneficiaries; CDC and employer-based wellness programs; coverage of preventive health services; immunizations; community health insurance option; level playing field; State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid; ensuring the quality of care; affordable choices of health benefit plans; national strategy to improve health care quality; interagency Working Group on Health Care Quality; quality measure development; quality measurement; data collection; public reporting; health care delivery system research; quality improvement technical assistance; demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals; transparency reports and reporting of physician ownership or investment interests; prescription drug sample transparency; pharmacy benefit managers transparency requirements; national health care workforce commission; health care workforce assessment; public health workforce recruitment and retention programs; allied health workforce recruitment and retention programs; grants for State and local programs; training in family medicine, general internal medicine, general pediatrics, and physician assistantship; geriatric education and training: career awards, comprehensive geriatric education; United States Public Health Sciences Track; interdisciplinary, community-based linkages (to support the existing health care workforce); and Medicare vaccine coverage issues (Medicare Part B vs. Part D).] Public Law 111-31 - Family Smoking Prevention and Tobacco Control Act on smoking cessation, advertising and marketing of tobacco products; and sale and distribution of tobacco. [Regulation Identifier Number (RIN) 0991-AB54] HIPAA Administrative Simplification: Standards for Privacy of Individually Identifiable Health Information [Genetic Information Nondiscrimination Act of 2008 (GINA)] [Regulation Identifier Number (RIN) 0991AB55] HIPAA Administrative Simplification: Enforcement HHS Draft Healthy People 2020 Objectives Concept - Role of Pharmacist-Provided Patient Care Services in Health Care Reform Concept - Include Pharmacists and Pharmacies in H1N1 and seasonal flu immunization activities Concept - National Health Service Corp

Client expense: $149,615 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

Aging, Health Care Workforce and Medicare, including H.R. 3590, H.R. 3962, S. 750, S. 1340 and H.R. 2244 and funding for health care programs in Labor/HHS bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 107-110 - Elementary and Secondary Education Act Reauthorization H.R. 2792 - Family & Medical Leave Inclusion Act SAVE Act S. 245/H.R. 468 -Retooling the Health Care Workforce for an Aging America Act of 2009 S. 2708/H.R. 7302 - (110th Congress) Health Professions & Primary Care Reinvestment Act H.R. 1457 -Geriatrics Loan Forgiveness Act of 2009 S. 750/H.R. 468 Caring for an Aging America Act P.L. 108-355 - Garrett Lee Smith Memorial Act H.R. 4223 -The Academic, Social, and Emotional Learning Act of 2009 H.R. 2597 - The Positive Behavior for Safe and Effective Schools Act School climate Zero tolerance H.R. 4925 - Healthy Media for Youth Act FY11 America COMPETES legislation FY11 National Science Foundation appropriations bills

Client expense: $133,400 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Motor Carrier Safety Administration, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Indian Health Service, Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Aeronautics & Space Administration (NASA), Natl Highway Traffic Safety Administration (NHTSA), Natl Institute of Mental Health (NIMH), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Office on Violence Against Women, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and provisions included in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation in healthcare reform on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reduce wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). S.750 Caring for an Aging America Act - Discussed as possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation to make improvements in the Patient Protection and Affordable Care Act. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/ S.1796, America's Healthy Future Act - Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments.

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

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

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and provisions included in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation in healthcare reform on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reduce wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). S.750 Caring for an Aging America Act - Discussed as possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation to make improvements in the Patient Protection and Affordable Care Act. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/ S.1796, America's Healthy Future Act - Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments.

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

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

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

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

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

Universal Coverage. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590: provisions providing health care or insurance for all U.S. residents and to control the cost and enhance the quality of the health care system. Importation of Prescription Drugs. H.R. 3590, H.R. 163, H.R. 1298, S. 525: provisions facilitating the importation of prescription drugs. Health Information Technology. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 1031, H.R. 1039, S. 179, S. 444: provisions facilitating the adoption of modern information technology. Generic Drugs. S. 369: provision to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market. Long-Term Services and Supports. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, Senate Finance Committee Mark of Americas Healthy Futures Act: provisions providing assistance to individuals with functional impairments maintain their independence, authorizing establishment of a community living infrastructure, and providing assistance to family caregivers (CLASS Act). Healthcare Workforce. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 468, S. 245, S. 750, H.R. 3098: provisions relating to the recruitment, training, and support of health care professionals and direct care workers in support of older Americans. Affordability of Health Coverage for Seniors. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 3962, S.1679: provisions reducing allowable age rating ratio for health insurance premiums.

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

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

1. S. 750, the "Caring for an Aging America Act of 2009," a bill to provide for the establishment of a new geriatric and gerontology loan repayment program. Support all provisions. 2. S. 245/H.R. 468, the "Retooling the Health Care Workforce for an Aging American Act of 2009". This bill addresses the current and future shortage of health care personnel who are trained to care for older adults. Support all provisions. 3. S. 682, the "Mental Health on Campus Improvement Act," to amend the Public Health Service Act to improve mental and behavioral services on college campuses. Support all provisions. 4. S. 697, the "Community Living Assistance Supports and Services Act (CLASS Act)," to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment. Support all provisions. Support inclusion of provisions of this bill in healht care reform legislation (H.R. 3590). 5. H.R. 1457, the "Geriatrics Loan Forgiveness Act of 2009," to amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, which provides up to $50,000 to repay student loans in exchange for working for two years in a high-need Health Professional Shortage Area. Support all provisions. 6 Discussed with House and Senate staff the need to include older adults in clinical trials. 7. Support comparative effectiveness research focused specifically on treatments for older adults and mental illness. 8 Support programs to reverse the declining numbers of geriatric specialists. 9. Support adoption of a 2:1 cap on age rating in health insurance systems in health care reform legislation (H.R. 3590). 10. Support legislation to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. 11. H.R. 1932/S. 999, the "Child Health Care Crisis Relief Act," to address the national shortage of children's mental health professionals, including school-based professionals, by encouraging more individuals to enter these critical fields. 12. S. 678, "Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009". Support all provisions, but especially those that strengthen protections for those in the criminal and juvenile justices systems with needs related to mental health and substance abuse. 13. H.R. 2901, "Healthy Transitions Act," to provide access to knowledge, skills, and supports that are necessary for a successful transition to adulthood for young adults with mental health disorders. The bill would provide technical and monetary assistance to states as they implement plans to develop a coordinated service delivery system in order to maximize continuity of care and access to services. The bill would also establish planning and implementation grants to assist peer support programs and programs promoting independent living, life skills, employment, and education. 14. H.R. 1193, the "Federal Response to Eliminate Easting Disorders Act," to create Centers of Excellence dedicated to research collaboration, create a Center of Epidemiology to study the prevalence, economic impact and related morbidity and mortality rates of eating disorders, provide for evidence-based standards of care, establish education and prevention grant programs for training of health professionals and schools at all levels, provide public service announcements, and enhance access to care for those who suffer from eating disorders. 15. H.R. 2531, the "Mental Health in Schools Act of 2009," to authorize competitive grants to local school districts to assist them in early mental health interventions and referrals for treatment, to provide supports for students and their families, and to allow for staff training to be culturally and linguistically appropriate. 16. H. R. 3191, the "Positive Aging Act," to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. Support all provisions. 17. Support language in the health care reform bills (H.R. 3590) to ensure coverage of critical services and supplies in a federal benefit standard and to require a fully open, transparent, and inclusive process for development of the standard that ensures full engagement of consumers, patients, workers and providers. 18. Support S. 1857 and H. R. 4204, to establish national centers of excellence for the treatment of depression and bipolar disorders. Support inclusion of that language in the health care reform bill (H.R. 3590). 19. Support H. R. 3590, the health care overhaul bill (the "Patient Protection and Affordable Care Act") and H. R. 4872, the reconciliation bill (the "Health Care and Education Reconciliation Act of 2010") to modify the healht care overhaul bill. 20. Support S. 2928, to include direct care workers as a priority for the National Health Care Workforce Commission and support inclusion of that language in the health care reform bill (H. R. 3590). 25. Support provisions in H.R. 3590, the "Patient Protection and Affordable Care Act," to strengthen existing Title VII geriatric health professions education programs. 26. Support reauthorization of the Substance Abuse and Mental Health Services Administration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3200 America's Affordable Health Choices Act S.1004/H.R. 2307 Reaching Elders with Assessment and Chronic Care Coordination Act. All provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaries with multiple chronic illnesses, including dementia. S697/HR1721, The Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S750, Caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S245/HR468 - Retooling for an Aging America, Building the Heatlhcare workforce. All provisions relating to expanding education and training opportunities in geriatric and long-term care for licensed health professionls, direct care workers, and family caregivers.

Client expense: $90,000 · Firm income: Not reported

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

H.R. 3200 America's Affordable Health Choices Act S.1004/H.R. 2307 Reaching Elders with Assessment and Chronic Care Coordination Act. All provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaries with multiple chronic illnesses, including dementia. HR3590 Patient Protection and Affordable Care Act S697/HR1721, The Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S750, Caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S245/HR468 - Retooling for an Aging America, Building the Heatlhcare workforce. All provisions relating to expanding education and training opportunities in geriatric and long-term care for licensed health professionls, direct care workers, and family caregivers. S1004, Realigning Care Act, All Sections HR632/S557 National Silver Alert Act HR4123/S2809 Alzheimer's Treatment & Caregiver Support Act

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

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

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and including provisions in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation and amendment on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and urged it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population age rating and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - To let Americans aged 55-64 who are otherwise without access to grup or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). H.R. 3293, Labor, HHS, Education and related agencies Appropriations bill for FY2010-Lobbied for funding for SSA, Older Americans Act programs, Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act). S.750 Caring for an Aging America Act - Discussed possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act, America's Healthy Future Act (no Senate bill)- Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. S. 2926, Economic Fairness for Seniors Act - Discussed legislation that would allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries, provide social security beneficiaries with $250 in economic relief in response to the lack of cost of living adjustment for 2010, and convert from the CPI-W to the CPI-E. H.J.Res. 64, Third Continuing Resolution, FY 2010; not enacted - Lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. H.R. 3326, Division B, Defense Appropriations bill for FY 2010 - Lobbied for SNAP participation changes, extension of unemployment benefits and COBRA eligibility, delay in cuts to Medicare physician payments. H.R. 2996, Division B, Interior Appropriations bill lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico seniors in Medicare Part B. (no bill) Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico and the territories, and the auto-enrollment of Puerto Rico seniors in Medicare Part B. (no bill)

Client expense: $5,950,000 · Firm income: Not reported

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

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and including provisions in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation and amendment on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and urged it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population age rating and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reducing wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - To let Americans aged 55-64 who are otherwise without access to grup or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). H.R. 3293, Labor, HHS, Education and related agencies Appropriations bill for FY2010-Lobbied for funding for SSA, Older Americans Act programs, Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act). S.750 Caring for an Aging America Act - Discussed possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. Discussed proposals to address LTC and HCBS in the context of health care reform. (no bill) S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act, America's Healthy Future Act (no Senate bill)- Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. S. 2926, Economic Fairness for Seniors Act - Discussed legislation that would allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries, provide social security beneficiaries with $250 in economic relief in response to the lack of cost of living adjustment for 2010, and convert from the CPI-W to the CPI-E. H.J.Res. 64, Third Continuing Resolution, FY 2010; not enacted - Lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. H.R. 3326, Division B, Defense Appropriations bill for FY 2010 - Lobbied for SNAP participation changes, extension of unemployment benefits and COBRA eligibility, delay in cuts to Medicare physician payments. H.R. 2996, Division B, Interior Appropriations bill lobbied for various items to be excepted from lower funding levels during the term of the Continuing Resolution. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico seniors in Medicare Part B. (no bill) Discussed support for the inclusion of Puerto Rico and the territories in the proposed Health Insurance Exchange, increasing Medicaid funds to Puerto Rico and the territories, and the auto-enrollment of Puerto Rico seniors in Medicare Part B. (no bill)

Client expense: $5,950,000 · Firm income: Not reported

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

S 750 - Caring for an Aging America Act HR 2891 - Access to Frontline Health Care Act of 2009 HR 756/S 660 - National Pain Care Policy Act of 2009 Under Line 17: We would like to include the Agency for Healthcare Research and Quality (AHRQ) HR 1259 - Dextromethorphan Distribution Act of 2009 HR 1256 - Family Smoking Prevention and Tobacco Control Act on smoking cessation, advertising and marketing of tobacco products; and sale and distribution of tobacco. S 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research. HR 2345 - Amends the Fair Credit Reporting Act to provide for an exclusion from Red Flag Guidelines for health care practices S 1213 - Patient-Centered Outcomes Research Act of 2009 S 1679 Affordable Health Choices Act [Sections on: ensuring quality of care; affordable choices of health benefit plans; seeking the best medical advice; spending for Federally Qualified Health Centers; national strategy; presentation of drug information; center for health outcomes research and evaluation; administrative simplification; right choices program; grants to establish community health teams to support a medical home model; grants to implement medication therapy management services in treatment of chronic disease; national health care workforce commission; funding for National Health Service Corps; geriatric education and training, career awards, comprehensive geriatric education; nurse education, practice, and retention grants; increasing Access to clinical preventive services, and increase prevention and wellness provisions.] HR 3200 - America's Affordable Health Choices Act of 2009 [Sections on: ensuring adequacy of provider networks; essential benefits package defined; Health Benefits Advisory Committee; outreach and enrollment of exchange-eligible individuals and employers in Exchange-participating health benefits plan; payment rates for items and services; reducing potentially preventable hospital readmissions; post acute care services payment reform plan; requiring drug manufacturers to provide drug rebates for certain, full premium subsidy eligible individuals; phasedin elimination of coverage gap; repeal of provision relating to submission of claims by pharmacies located in or contracting with long-term care facilities; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out of pocket threshold under part D; permitting mid-year changes in enrollment; telehealth expansion and enhancements; intelligent assignment in enrollment; ensuring effective communication in Medicare; Accountable Care Organization pilot program; medical home pilot program; coverage and waiver of cost-sharing for preventive services; comparative effectiveness research; reports on financial relationships between manufacturers and distributors of covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid, or CHIP and physicians and other health care entities and between physicians and other health care entities; distribution of unused residency positions; require providers and suppliers to adopt programs to reduce waste, fraud, and abuse; payments to pharmacists (AMP); Task Force on Clinical Preventive Services; fully integrated dual eligible special needs plans; public health and workforce development; prevention and wellness; preventive cost sharing services; amendments to establish a medication therapy management grant program, pharmacy benefit manager transparency; and allowing direct price negotiations in Medicare Part D.] S 1796 - America's Healthy Future Act of 2009 [Sections on: health care coverage, including sections on the Health Benefits Advisory Committee, making coverage affordable, Medicaid coverage for the lowest income populations, Medicaid prescription drug coverage, changes to Medicaid payment for prescription drugs (AMP); Medicaid quality; promoting disease prevention and wellness including sections on Medicare (annual wellness visit, study on beneficiary access to immunizations, removing barriers to preventive services, and incentives for healthy lifestyles) and Medicaid (improving access to preventive services for eligible adults, incentives for healthy lifestyles, and Medicaid state plan option promoting health homes and integrated care); improving the quality and efficiency of health care including sections on physician value-based purchasing, quality infrastructure, Accountable Care Organizations, and CMS Innovation Center; strengthening primary care and other workforce improvements; Medicare Part D improvements including sections improving coverage in the Part D coverage gap, facilitation of reassignments of beneficiaries in low-income subsidy plans, strengthening formularies with respect to certain categories or classes of drugs, and limitation on removal or change of coverage of covered Part D drugs under a formulary; Medicare Advantage including section on Medicare Advantage payment; home health payment changes including section on durable medical equipment; improving Medicare for patients and providers, including sections on Medicare diabetes self-management training, and revisions to demonstration project on community health integration models in certain rural counties; administrative simplification including section on changes to HIPAA; ensuring Medicare sustainability including section on Medicare Commission; transparency and program integrity including sections on physician payment sunshine and prescription drug samples; fraud, waste, and abuse including sections on provider screening, provider compliance and penalties; revenue items including sections on employer health insurance reporting, and annual fee on clinical laboratories; the inclusion of PBM transparency and the medications therapy management grant program in section 213 of S1679; and changes to long-term care pharmacy utilization management provisions.] HR 3962 - Affordable Health Care for America Act [Sections on: wellness program grants; administrative simplification; ensuring adequacy of provider networks; essential benefits package defined; requiring information transparency and plan disclosure; state prohibitions on discrimination against health care providers; protection of physician prescriber information; nondiscrimination on abortion and respect for rights of conscience; study and report on methods to increase electronic health record (EHR) use by small health care providers; contracts for the offering of exchange-participating health benefits plans; payment rates for items and services; modernized payment initiatives and delivery system reforms; provider participation under the public health insurance option; limitations on health care related expenditures including distributions for medicine qualified only if for prescribed drugs or insulin; excise tax on medical devices; permitting physician assistants to order post-hospital extended care services and to provide for recognition of attending physician assistants as attending physicians to serve hospice patients; resource-based feedback program for physicians in Medicare; modifications to the physician quality reporting initiative; home infusion therapy report to Congress; durable medical equipment (DME) program improvements; MedPAC study and report on bone mass measurement; payment for biosimilar biological products; study and report on DME competitive bidding process; reducing potentially preventable hospital readmissions; post-acute care services payment reform plan and bundling pilot program; Institute of Medicine study on geographic variation in health care spending and promoting high-value health care; implementation, and Congressional review, of proposal to revise Medicare payments to promote high-value health care; phase-in of payment based on fee-for-service costs; quality bonus payments for Medicare Advantage plans; improvements to Medicare Part D including elimination of coverage gap; discounts for certain Part D drugs in original coverage gap; repeal of provision relating to submission of claims by pharmacies located in or contracting with long-term care facilities; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under Part D; no mid-year formulary changes permitted; negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries; accurate dispensing in long-term care facilities and free generic fill; elimination of part D cost-sharing for certain non-institutionalized full-benefit dual-eligible individuals; intelligent assignment in enrollment; demonstration to promote access for Medicare beneficiaries with limited English proficiency by providing reimbursement for culturally and linguistically appropriate services; accountable care organization pilot program; medical home pilot program; coverage and waiver of cost-sharing for preventive services; expanding access to vaccines; expansion of Medicare-covered preventive services at Federally Qualified Health Centers; independence at home demonstration program; recognition of certified Diabetes Educators as certified providers for purposes of Medicare Diabetes outpatients self-management training services; comparative effectiveness research; establishment of national priorities for quality improvement; development of new quality measures; GAO evaluation of data collection process for quality measurements; multi-stakeholder pre-rulemaking input into selection of quality measures; application of quality measures; reports on financial relationships between manufacturers and distributors of covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid, or CHIP and physicians and other health care entities and between physicians and other health care entities; requirement for public reporting by hospitals and ambulatory surgical centers on health care-associated infections; pharmacy benefit managers transparency requirements; increased funding and flexibility to fight fraud and abuse; enhanced penalties for false statements on provider or supplier enrollment applications; enhanced penalties for submission of false statements material to a false claim; enhanced penalties for delaying inspections; enhanced hospice program safeguards; enhanced penalties for individuals excluded from program participation; enhanced penalties for obstruction of program audits; exclusion of certain individuals and entities from participation in Medicare and State health care programs; enhanced CMS program protection authority; enhanced Medicare, Medicaid and CHIP program disclosure requirements relating to previous affiliations; require providers and suppliers to adopt programs to reduce waste, fraud and abuse; maximum period for submission of Medicare claims reduced to not more than 12 months; telehealth expansion and enhancements; physicians who order DME or home health services required to be Medicare enrolled physicians or eligible professionals; face-to-face encounter with patient required before eligibility certifications for home health services or DME; required repayments of Medicare and Medicaid overpayments; expanded application of hardship waivers for OIG exclusions to beneficiaries of any federal health care program; requiring provider and supplier payments under Medicare to be made through direct deposit or electronic funds transfer at insured depository institutions; under Medicaid and CHIP, required coverage of preventive services, tobacco cessation, medical home pilot program, inclusion of public health clinics under the vaccines for children program, accountable care organization pilot program, state option to disregard certain income in providing continued Medicaid coverage for certain individuals with extremely high prescription, payments to pharmacists (AMP), assuring adequate payment levels for services; report on Medicaid payments, health care acquired conditions, require providers and suppliers to adopt programs to reduce waste, fraud and abuse, overpayments, termination of provider participation under Medicaid and CHIP if terminated under Medicare or other State plan or Child health plan, Medicaid and CHIP exclusion from participation relating to certain ownership, control and management affiliations; requirement to report expanded set of data elements under Medicaid Management Information System to detect fraud and abuse, and extension of QI program; improved coordination and protection for dual-eligibles; assessment of Medicare cost-intensive diseases and conditions; establishment of Center for Medicare and Medicaid Innovation within CMS; frontline health providers loan repayment program; health workforce evaluation and assessment; improving accountability for approved medial residency training; other health care workforce issues; prevention and wellness; implementation of best practices in the delivery of health care; assistant Secretary for health information; expanded participation in 340B Program; improvements to 340B program integrity; No Child Left Unimmunized Against Influenza: demonstration program using elementary and secondary schools as influenza vaccination centers; implementation of medication management services in treatment of chronic diseases; community-based collaborative care networks; institute of medicine conference on pain; pain research at NIH; public awareness campaign on pain management; licensure pathway for biosimilar biological products; and Indian Health Care Improvement.] HR 3590 - Patient Protection and Affordable Care Act [Sections on: reinsurance for early retirees; non-discrimination in health care; essential health benefits requirements; financial integrity in Exchanges; MedPAC study on adequacy of Medicare payments for health care providers serving in rural areas; coverage of comprehensive tobacco cessation services for pregnant women in Medicaid; distributions for medicine qualified only if for prescribed drug or insulin; administrative simplification; payment for biosimilar biological products; approval pathway for biosimilar biological products; patient-centered outcomes research; special rules; prohibition against discrimination on assisted suicide; presentation of prescription drug benefit and risk information; provider screening and other enrollment requirements under Medicare, Medicaid, and CHIP; enhanced Medicare and Medicaid program integrity provisions; maximum period for submission of Medicare claims reduced to not more than 12 months; physicians who order items or services required to be Medicare enrolled physicians or eligible professionals; requirement for physicians to provide documentation on referrals to programs at high risk of waste and abuse; face to face encounter with patient required before physicians may certify eligibility for home health services or durable medical equipment under Medicare; enhanced penalties; adjustments to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program; termination of provider participation under Medicaid if terminated under Medicare or other State plan; Medicaid exclusion from participation relating to certain ownership, control, and management affiliations; health information technology enrollment standards and protocols; improvements to the physician quality reporting system; hospital readmissions reduction program; community-based care transitions program; Medicare Advantage payment; demostration project to evaluate integrated care around a hospitalization; state option to provide health homes for enrollees with chronic conditions; pediatric accountable care organization demonstration project; establishment of Center for Medicare and Medicaid Innovation within CMS; Medicare shared savings program; national pilot program on payment bundling; independence at home demonstration program; establishing community health teams to support the patient-centered medical home; Medicaid coverage for the lowest income populations; elimination of exclusion of coverage of certain drugs; providing adequate pharmacy reimbursement (AMP); exemption of certain pharmacies from DMEPOS accreditation requirements; payment adjustments for home health care; Medicare coverage gap discount program; immediate reduction in coverage Medicare Part D gap in 2010; improved information for subsidy eligible individuals reassigned to prescription drug plans and MAPD plans; improving formulary requirements for prescription drug plans and MAPD plans with respect to certain categories or classes of drugs; elimination of cost sharing for certain dual eligible individuals; uniform exceptions and appeals process for prescription drug plans and MAPD plans; Office of the Inspector General studies and reports; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under part D; reducing wasteful dispensing of outpatient prescription drugs in long-term care facilities under prescription drug plans and MAPD plans; medication management services in treatment of chronic disease; advancing research and treatment for pain care management; National Prevention, Health Promotion and Public Health Council; clinical and community preventive services; Medicare coverage of annual wellness visit providing a personalized prevention plan; removal of barriers to preventive services in Medicare; incentives for prevention of chronic diseases in Medicaid; community transformation grants; healthy aging, living well - evaluation of community-based prevention and wellness programs for Medicare beneficiaries; CDC and employer-based wellness programs; coverage of preventive health services; immunizations; community health insurance option; level playing field; State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid; ensuring the quality of care; affordable choices of health benefit plans; national strategy to improve health care quality; interagency Working Group on Health Care Quality; quality measure development; quality measurement; data collection; public reporting; health care delivery system research; quality improvement technical assistance; demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals; transparency reports and reporting of physician ownership or investment interests; prescription drug sample transparency; pharmacy benefit managers transparency requirements; national health care workforce commission; health care workforce assessment; public health workforce recruitment and retention programs; allied health workforce recruitment and retention programs; grants for State and local programs; training in family medicine, general internal medicine, general pediatrics, and physician assistantship; geriatric education and training: career awards, comprehensive geriatric education; United States Public Health Sciences Track; interdisciplinary, community-based linkages (to support the existing health care workforce); Amendments: Improvements in Medicare Part D MTM programs in Freshman Amendments; Modernize Americas health care system provide for a performance-based pharmacy reimbursement program under Medicare part D (S.A. 3119); Pharmaceutical Market Access and Drug Safety Act of 2009 (S.A. 2793) Provide for establishment and maintenance of chronic care pharmacy program (S.A. 3109).] Public Law 111-3 - Reauthorization of Childrens Health Insurance Plans on pharmacist appointment to MEDPAC [Regulation Identifier Number (RIN) 0991-AB54] HIPAA Administrative Simplification: Standards for Privacy of Individually Identifiable Health Information [Genetic Information Nondiscrimination Act of 2008 (GINA)] [Regulation Identifier Number (RIN) 0991AB55] HIPAA Administrative Simplification: Enforcement (Docket No. FDA-2009-N-0247) FDA Transparency Task Force; Request for Comments (Docket Number FDA2009N0441) Promotion of Food and Drug Administration-Regulated Medical Products Using the Internet and Social Media Tools; Notice of Public Hearing (Docket Number DEA321a) Identification of Institution-based Individual Practitioners (Docket No. FDA2009N0294) Regulation of Tobacco Products; Request for Comments AHRQ Proposed Collection Project: Health IT Community Tracking Study 2009 HHS Draft Healthy People 2020 Objectives Concept - Role of Pharmacist-Provided Patient Care Services in Health Care Reform Concept - Include Pharmacists and Pharmacies in 2009 H1N1 and seasonal flu immunization activities Concept - National Health Service Corp

Client expense: $117,517 · Firm income: Not reported

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

S 1679, Affordable Health Choices Act, provisions pertaining to social work and workforce enhancement programs. HR 3200, America's Affordable Health Choices Act of 2009, provisions pertaining to social work and health professions workforce. HR 3090, Health Equity and Accountability Act of 2009, provisions pertaining to health professions workforce, education, research, and training. S. 1796, America's Healthy Future Act of 2009, provisions pertaining to social work and workforce enhancement programs. HR 2708, Indian Health Care Improvement Act, provisions relating to health professions.. S 252, Veterans Health Care Authorization Act, issues regarding scholarship programs and VA social work workforce needs. HR 1457, Geriatrics Loan Forgiveness Act, issues pertaining to health professions. HR 1928, Home Healthcare Nurse Promotion Act, provisions pertaining to loan forgiveness. HR 3191, Positive Aging Act of 2009, all provisions relating to mental health services. HR 468/S 245, Retooling the Health Care Workforce for an Aging America Act, provisions pertaining to social work, education and training programs. HR 1932/S 999, Child Health Care Crisis Relief Act, all provisions pertaining to education and training. HR 3098/S 750, Caring for an Aging America Act, all provisions pertaining to education and training. S 697/HR 1721, Community Living Assistance Services and Supports Act, all provisions. HR 3962, Affordable Health Care for America Act, provisions pertaining to health professions workforce, education, and training programs. HR 3590/S 1728, Patient Protection and Affordable Care Act, provisions pertaining to the CLASS Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Aging, Health Care Workforce and Medicare, including H.R. 3590, H.R. 3962, S. 750, S. 245, S. 1004, H.R. 468, H.R. 2307, H.R. 3200 and health care reform bills. Appropriations funding for Title VII geriatrics health professions programs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.478: A bill to amend the National Labor Relations Act, to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. S. 245 A bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States. S. 560: A bill to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during the organizing efforts, and for other purposes. S. 245: Retooling the Health Care Workforce for an Aging Science Act of 2009. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 468: Retooling the Health Care Workforce for an Aging Science Act of 2009. H.R. 1409: To amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes. H.R. 1176: To amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. H.R. 2536: A bill to provide relief for the shortage of nurses in the United States. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. S. 1022: A bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members. H.R. 2381: To direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes. S. 478: A bill to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. H.R.3191: To amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes. H.R. 1946:To amend the Public Health Service Act to address health workforce shortages. H.R. 1460: To amend the Public Health Service Act to establish a graduate degree for loan repayment program for nurses who become nursing school faculty members. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes.

Client expense: $440,000 · Firm income: Not reported

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

H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S. 1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 1: Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes. H.R. 2: The Children's Health Insurance Program Reauthorization Act of 2009, establishing a Medicaid and CHIP Payment and Access Commission (MACPAC). This new Commission will provide Congress with a new, credible forum to discuss specific ways to strengthen the nation's Medicaid payment system, and ensure the growing needs of America's most vulnerable, frail, elderly and the disabled beneficiaries are met and in the years ahead. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 1255: A bill which protects the interests of each resident of intermediate care facilities for the mentally retarded or developmentally disabled (ICFs/MRDD) in related class action lawsuits. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796: America's Healthy Future Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 632: To encourage, enhance, and integrate Silver Alert plans throughout the United States, to authorize grants for the assistance of organizations to find missing adults, and for other purpose. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by a team of qualified and experienced health care professionals. S. 1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. H.R. 1255: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. H.R. 632: To encourage, enhance, and integrate Silver Alert plans throughout the United States, to authorize grants for the assistance of organizations to find missing adults, and for other purposes. H.R. 1457: To amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, and for other purposes. H.R. 3191: To amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes. H.R. 3962: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 3590: The Patient Protection and Affordable Care Act. S. 1679 An original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers.

Client expense: $440,000 · Firm income: Not reported

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

Universal Coverage. H.R. 3590, H.R. 3962, H.R.15, H.R.193, H.R. 676, H.R.1200, S. 4: provisions providing health care or insurance for all U.S. residents and to control the cost and enhance the quality of the health care system. Importation of Prescription Drugs. H.R. 3590, H.R. 163, H.R. 1298, S. 525: provisions facilitating the importation of prescription drugs. Health Information Technology. H.R. 1031, H.R. 1039, S. 179, S. 444: provisions facilitating the adoption of modern information technology. Generic Drugs. S. 369: provision to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market. Long-Term Services and Supports. H.R. 3590, H.R. 3962, S. 697/H.R.1721, H.R. 3200, S. 1679, Senate Finance Committee Mark of Americas Healthy Futures Act: provisions providing assistance to individuals with functional impairments maintain their independence, authorizing establishment of a community living infrastructure, and providing assistance to family caregivers (CLASS Act). Healthcare Workforce. H.R. 3590, H.R. 3962, H.R. 468/S. 245, S. 750, H.R. 3098: provisions relating to the recruitment, training, and support of health care professionals and direct care workers in support of older Americans. Affordability of Health Coverage for Seniors. H.R. 3590, H.R. 3962, S.1679: provisions reducing allowable age rating ratio for health insurance premiums.

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

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

1. Discussed with House staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. S. S. 750, the "Caring for an Aging America Act of 2009," a bill to provide for the establishment of a new geriatric and gerontology loan repayment program. Support all provisions. 3. S. 245/H.R. 468, the "Retooling the Health Care Workforce for an Aging America Act of 2009". This bill addresses the current and future shortage of health care personnel who are trained to care for older adults. Support all provisions. 4. S. 682, the "Mental Health on Campus Improvement Act," to amend the Public Health Service Act to improve mental and behavioral services on college campuses. Support all provisions. 5. S. 697, the "Community Living Assistance Supports and Services Act (CLASS Act)," to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment. Support all provisions. Support inclusion of provisions of this bill in healht care reform legislation (H.R. 3590). 6. H.R. 1457, the "Geriatrics Loan Forgiveness Act of 2009," to amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, which provides up to $50,000 to repay student loans in exchange for working for two years in a high-need Health Professional Shortage Area. Support all provisions. 7. Discussed with House and Senate staff the need to include older adults in clinical trials. 8. Support involvement of geriatric specialists in development of medical homes. 9. Support patient privacy protections for health information systems. 10. Support comparative effectiveness research focused specifically on treatments for older adults and mental illness. 11. Support programs to reverse the declining numbers of geriatric specialists. 12. Oppose permitting age discrimination in insurance ratings in private or public health insurance systems. 13. Support legislation to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. 14. Request Senate hearing to discuss opportunities within health reform to ameliorate and eliminate disparities in health status and health services. 15. H.R. 1932/S. 999, the "Child Health Care Crisis Relief Act," to address the national shortage of children's mental health professionals, including school-based professionals, by encouraging more individuals to enter these critical fields. 16. S. 678, "Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009". Support all provisions, but especially those that strengthen protections for those in the criminal and juvenile justices systems with needs related to mental health and substance abuse. 17. H.R. 2901, "Health Transitions Act," to provide access to knowledge, skills, and supports that are necessary for a successful transition to adulthood for young adults with mental health disorders. The bill would provide technical and monetary assistance to states as they implement plans to develop a coordinated service delivery system in order to maximize continuity of care and access to services. The bill would also establish planning and implementation grants to assist peer support programs and programs promoting independent living, life skills, employment, and education. 18. H.R. 1193, the "Federal Response to Eliminate Easting Disorders Act," to create Centers of Excellence dedicated to research collaboration, create a Center of Epidemiology to study the prevalence, economic impact and related morbidity and mortality rates of eating disorders, provide for evidence-based standards of care, establish education and prevention grant programs for training of health professionals and schools at all levels, provide public service announcements, and enhance access to care for those who suffer from easting disorders. 19. H.R. 2531, the "Mental Health in Schools Act of 2009," to authorize competitive grants to local school districts to assist them in early mental health interventions and referrals for treatment, to provide supports for students and their families, and to allow for staff training to be culturally and linguistically appropriate. 20. H.R. 3191, the "Positive Aging Act", to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. Support all provisions. 21. Support language in House and Senate health care reform bills (H.R. 3962/H.R. 3590) to ensure coverage of critical services and supplies in a federal benefit standard and to require a fully open, transparent, and inclusive process for development of the standard that ensures full engagement of consumers, patients, workers and providers. 22. Support S. 1857 and H. R. 4204, to establish national centers of excellence for the treatment of depression and bipolar disorders. Support inclusion of that language in Senate health care reform bill (H.R. 3590). 23. Support H. R. 3962, the "Affordable Health Care for American Act," health care reform bill approved by the House of Representatives. 24. Support S. 2928, to include direct care workers as a priority for the National health Care Workforce Commission and support inclusion of that language in the Senate health care reform bill (h.R. 3590). 25. Support provisions in H.R. 3590, the "Patient Protection and Affordable Care Act," to strengthen existing Title VII geriatric health professions education programs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3200 America's Affordable Health Choices Act S.1004/H.R. 2307 Reaching Elders with Assessment and Chronic Care Coordination Act. All provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaries with multiple chronic illnesses, including dementia. S697/HR1721, The Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S750, Caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S245/HR468 - Retooling for an Aging America, Building the Heatlhcare workforce. All provisions relating to expanding education and training opportunities in geriatric and long-term care for licensed health professionls, direct care workers, and family caregivers.

Client expense: $90,000 · Firm income: Not reported

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

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

Client expense: $5,680,000 · Firm income: Not reported

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

H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S. 1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 1: Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes. H.R. 2: The Children's Health Insurance Program Reauthorization Act of 2009, establishing a Medicaid and CHIP Payment and Access Commission (MACPAC). This new Commission will provide Congress with a new, credible forum to discuss specific ways to strengthen the nation's Medicaid payment system, and ensure the growing needs of America's most vulnerable, frail, elderly and the disabled beneficiaries are met and in the years ahead. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation, and for other purposes. H.R. 43: To amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 1255: A bill which protects the interests of each resident of intermediate care facilities for the mentally retarded or developmentally disabled (ICFs/MRDD) in related class action lawsuits. H.R. 448: Elder Abuse Victims Act of 2009. H.R. 3200: America's Affordable Health Choices Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. S. 1796: America's Healthy Future Act of 2009. To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. H.R. 632: To encourage, enhance, and integrate Silver Alert plans throughout the United States, to authorize grants for the assistance of organizations to find missing adults, and for other purpose. S. 1131: A bill to amend title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan fo care developed by a team of qualified and experienced health care professionals. S. 1004: A bill to amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes. S. 702: A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under Cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance.

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

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

S.478: A bill to amend the National Labor Relations Act, to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. S. 245 A bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States. S. 560: A bill to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during the organizing efforts, and for other purposes. S. 245: Retooling the Health Care Workforce for an Aging Science Act of 2009. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 468: Retooling the Health Care Workforce for an Aging Science Act of 2009. H.R. 1409: To amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes. H.R. 1176: To amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. H.R. 2536: A bill to provide relief for the shortage of nurses in the United States. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers. H.R. 1022: A bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members. H.R. 2381: To direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes. S. 478: A bill to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. H.R.3191: To amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes. H.R. 1946:To amend the Public Health Service Act to address health workforce shortages. H.R. 1460: To amend the Public Health Service Act to establish a graduate degree for loan repayment program for nurses who become nursing school faculty members.

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

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

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

Client expense: $5,680,000 · Firm income: Not reported

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

HR 3200, Senate HELP and Senate Finance health care reform draft legislation - advocated for inclusion of CLASS long-term care financing provisions and incentives for small non-profits to provide health insurance coverage to their employees. S. 750, Caring for an Aging America Act, to attract and retain trained health care professionals and direct care workers to care for people as they age - support. S. 245/HR 468, Retooling the Healthcare Workforce for an Aging America Act: would expand opportunities for health care professionals at all levels to obtain education and training in geriatrics and gerontology - support and advocate for inclusion of its provisions in health care reform.

Client expense: $116,068 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1679, Affordable Health Choices Act, Title II and IV, provisions pertaining to social work and workforce enhancement programs. HR 3200, America's Affordable Health Choices Act of 2009, Division C, provisions pertaining to social work and health professions workforce. HR 3090, Health Equity and Accountability Act of 2009, provisions pertaining to health professions workforce, education, research, and training. America's Healthy Future Act of 2009, provisions pertaining to social work and workforce enhancement programs. HR 2708, Indian Health Care Improvement Act, provisions relating to social work. S 252, Veterans Health Care Authorization Act, issues regarding scholarship programs and VA social work workforce needs. HR 1457, Geriatrics Loan Forgiveness Act, issues pertaining to social work, education and training. HR 1928, Home Healthcare Nurse Promotion Act, provisions pertaining to loan forgiveness. HR 3191, Positive Aging Act of 2009, all provisions relating to mental health services. HR 468/S245, Retooling the Health Care Workforce for an Aging America Act, Title I, Subtitle A, provisions pertaining to social work, education and training programs. HR 1932/S999, Child Health Care Crisis Relief Act, all provisions pertaining to education and training. HR 3098/S 750, Caring for an Aging America Act, all provisions pertaining to education and training. S 697/HR 1721, Community Living Assistance Services and Supports Act, all provisions.

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

HR756/S660 - National Pain Care Policy Act of 2009 HR179 - Community AIDS and Hepatitis Prevention Act S1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research. Under Line 17: We would like to include the Agency for Healthcare Research and Quality (AHRQ) HR2891 - Access to Frontline Health Care Act of 2009 HR1259 - Dextromethorphan Distribution Act of 2009 HR1256 - Family Smoking Prevention and Tobacco Control Act on smoking cessation, advertising and marketing of tobacco products; and sale and distribution of tobacco. HR2345 - Amends the Fair Credit Reporting Act to provide for an exclusion from Red Flag Guidelines for health care practices S256 - Combat Methamphetamine Enhancement Act of 2009 S750 - Caring for an Aging America Act S1213 - Patient-Centered Outcomes Research Act of 2009 HR676 - U.S. National Health Insurance Act on the inclusion of medication therapy management services S1679 & Draft Bill Affordable Health Choices Act (Sections on ensuring quality of care; affordable choices of health benefit plans; seeking the best medical advice; spending for Federally Qualified Health Centers (FQHCs); national strategy; presentation of drug information; center for health outcomes research and evaluation; administrative simplification; right choices program; grants to establish community health teams to support a medical home model; grants to implement medication management services in treatment of chronic disease; national health care workforce commission; funding for National Health Service Corps; geriatric education and training, career awards, comprehensive geriatric education; nurse education, practice, and retention grants; increasing Access to Clinical Preventive Services, and increase prevention and wellness provisions) HR3200 & Draft Bill - America's Affordable Health Choices Act of 2009 [Sections on ensuring adequacy of provider networks; essential benefits package defined; Health Benefits Advisory Committee; outreach and enrollment of exchange-eligible individuals and employers in Exchange-participating health benefits plan; payment rates for items and services; reducing potentially preventable hospital readmissions; post acute care services payment reform plan; requiring drug manufacturers to provide drug rebates for certain, full premium subsidy eligible individuals; phasedin elimination of coverage gap; repeal of provision relating to submission of claims by pharmacies located in or contracting with long-term care facilities; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out of pocket threshold under part D; permitting mid-year changes in enrollment; telehealth expansion and enhancements; intelligent assignment in enrollment; ensuring effective communication in Medicare; Accountable Care Organization pilot program; medical home pilot program; coverage and waiver of cost-sharing for preventive services; comparative effectiveness research; reports on financial relationships between manufacturers and distributors of covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid, or CHIP and physicians and other health care entities and between physicians and other health care entities; distribution of unused residency positions; require providers and suppliers to adopt programs to reduce waste, fraud, and abuse; payments to pharmacists; Task Force on Clinical Preventive Services; fully integrated dual eligible special needs plans (FIDESNP); public health and workforce development; prevention and wellness; preventive cost sharing services; Butterfield Amendment - Establishes an Medication Therapy Management Grant Program (House Engery and Commerce Committeee's HR3200); Weiner Amendment - Creates PBM Transparency (House Engery and Commerce Committeee's HR3200); and Schakowsky Amendment - Allows direct price negotiations in Medicare Part D (House Engery and Commerce Committeee's HR3200)] Draft Bill Access to Birth Control Act Chairman's Mark - America's Healthy Future Act of 2009 [sections on health care coverage including sections on the Health Benefits Advisory Committee, making coverage affordable, Medicaid coverage for the lowest income populations, Medicaid prescription drug coverage, changes to Medicaid payment for prescription drugs (AMP); Medicaid quality; promoting disease prevention and wellness including sections on Medicare (annual wellness visit, study on beneficiary access to immunizations, removing barriers to preventive services, and incentives for healthy lifestyles) and Medicaid (improving access to preventive services for eligible adults, incentives for healthy lifestyles, and Medicaid state plan option promoting health homes and integrated care); improving the quality and efficiency of health care including sections on physician value-based purchasing, quality infrastructure, Accountable Care Organizations, CMS Innovation Center; strengthening primary care and other workforce improvements; Medicare Part D improvements including sections improving coverage in the Part D coverage gap, facilitation of reassignments of beneficiaries in low-income subsidy plans, strengthening formularies with respect to certain categories or classes of drugs, and limitation on removal or change of coverage of covered Part D drugs under a formulary; Medicare Advantage including section on Medicare Advantage payment; home health payment changes including section on Durable Medical Equipment; improving Medicare for patients and providers including sections on Medicare Diabetes Self-Management Training, revisions to demonstration project on community health integration models in certain rural counties; administrative simplification including section on changes to HIPAA;ensuring Medicare sustainability including section on Medicare Commission; transparency and program integrity including sections on physician payment sunshine and prescription drug samples; fraud, waste, and abuse including sections on provider screening, provider compliance and penalties; revenue items including sections on employer health insurance reporting, annual fee on clinical laboratories; the inclusion of PBM transparency and the medications therapy management grant program in section 213 of S1679; and changes to long-term care pharmacy utilization management provisions] Concept - Role of Pharmacist-Provided Patient Care Services in any Integrated Care Model, Hospital Readmissions and Medication Therapy Management Services in Health Care Reform Concept - Include Pharmacists and Pharmacies in 2009 H1N1 and seasonal flu immunization activities (Docket No. FDA2009N0294) Regulation of Tobacco Products; Request for Comments AHRQ Proposed Collection Project: Health IT Community Tracking Study 2009

Client expense: $157,696 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, SENATE, White House Office

Aging, Health Care Workforce and Medicare, including S. 750, S. 245, S. 1004, H.R. 468, H.R. 2307, H.R. 3200 and health care reform bills. Appropriations funding for Title VII geriatrics health professions programs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Universal Coverage. H.R.15, H.R.193, H.R. 676, H.R.1200, S. 4: provisions providing health care or insurance for all U.S. residents and to control the cost and enhance the quality of the health care system. Importation of Prescription Drugs. H.R. 163, H.R. 1298, S. 525: provisions facilitating the importation of prescription drugs. Health Information Technology. H.R. 1031, H.R. 1039, S. 179, S. 444: provisions facilitating the adoption of modern information technology. Generic Drugs. S. 369: provision to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market. Long-Term Services and Supports. S. 697/H.R.1721, H.R. 3200, S. 1679, Senate Finance Committee Mark of Americas Healthy Futures Act: provisions providing assistance to individuals with functional impairments maintain their independence, authorizing establishment of a community living infrastructure, and providing assistance to family caregivers (CLASS Act). Healthcare Workforce. H.R. 468/S. 245, S. 750, H.R. 3098: provisions relating to the recruitment, training, and support of health care professionals and direct care workers in support of older Americans. Affordability of Health Coverage for Seniors. S.1679: provisions reducing allowable age rating ratio for health insurance premiums.

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

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

1. Discussed with House staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. S. S. 750, the "Caring for an Aging America Act of 2009," a bill to provide for the establishment of a new geriatric and gerontology loan repayment program. Support all provisions. 3. S. 245/H.R. 468, the "Retooling the Health Care Workforce for an Aging America Act of 2009". This bill addresses the current and future shortage of health care personnel who are trained to care for older adults. Support all provisions. 4. S. 682, the "Mental Health on Campus Improvement Act," to amend the Public Health Service Act to improve mental and behavioral services on college campuses. Support all provisions. 5. S. 697, the "Community Living Assistance Supports and Services Act (CLASS Act)," to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment. Support all provisions. 6. H.R. 1457, the "Geriatrics Loan Forgiveness Act of 2009," to amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, which provides up to $50,000 to repay student loans in exchange for working for two years in a high-need Health Professional Shortage Area. Support all provisions. 7. Discussed with House and Senate staff the need to include older adults in clinical trials. 8. Support involvement of geriatric specialists in development of medical homes. 9. Support patient privacy protections for health information systems. 10. Support comparative effectiveness research focused specifically on treatments for older adults and mental illness. 11. Support programs to reverse the declining numbers of geriatric specialists. 12. Oppose permitting age discrimination in insurance ratings in private or public health insurance systems. 13. Support legislation to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. 14. Request Senate hearing to discuss opportunities within health reform to ameliorate and eliminate disparities in health status and health services. 15. H.R. 1932/S. 999, the "Child Health Care Crisis Relief Act," to address the national shortage of children's mental health professionals, including school-based professionals, by encouraging more individuals to enter these critical fields. 16. S. 678, "Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009". Support all provisions, but especially those that strengthen protections for those in the criminal and juvenile justices systems with needs related to mental health and substance abuse. 17. H.R. 2901, "Health Transitions Act," to provide access to knowledge, skills, and supports that are necessary for a successful transition to adulthood for young adults with mental health disorders. The bill would provide technical and monetary assistance to states as they implement plans to develop a coordinated service delivery system in order to maximize continuity of care and access to services. The bill would also establish planning and implementation grants to assist peer support programs and programs promoting independent living, life skills, employment, and education. 18. H.R. 1193, the "Federal Response to Eliminate Easting Disorders Act," to create Centers of Excellence dedicated to research collaboration, create a Center of Epidemiology to study the prevalence, economic impact and related morbidity and mortality rates of eating disorders, provide for evidence-based standards of care, establish education and prevention grant programs for training of health professionals and schools at all levels, provide public service announcements, and enhance access to care for those who suffer from easting disorders. 19. H.R. 2531, the "Mental Health in Schools Act of 2009," to authorize competitive grants to local school districts to assist them in early mental health interventions and referrals for treatment, to provide supports for students and their families, and to allow for staff training to be culturally and linguistically appropriate. 20. H.R. 3191, the "Positive Aging Act", to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. Support all provisions. 21. Support language in House and Senate health care reform bills (H.R. 3200/S. 1679/draft Senate bill) to ensure coverage of critical services and supplies in a federal benefit standard and to require a fully open, transparent, and inclusive process for development of the standard that ensures full engagement of consumers, patients, workers and providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.1004/H.R. 2307 Reaching Elders with Assessment and Chronic Care Coordination Act. All provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaries with multiple chronic illnesses, including dementia. S697/HR1721, The Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S750, Caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S245/HR468 - Retooling for an Aging America, Building the Heatlhcare workforce. All provisions relating to expanding education and training opportunities in geriatric and long-term care for licensed health professionls, direct care workers, and family caregivers. HR1 - Healthcare provisions in the American Recovery and Reinvestment Act No bill number - health care reform legislation S.1150/HR 2911 - Advance Planning and Compassionate Act of 2009 - Establishes and operates directly or by grant, contract or interagency agreement, a 24-hour toll free telephone hotline to provide consumer information regarding advance planning.

Client expense: $90,000 · Firm income: Not reported

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

1. Discussed with House staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. S. S. 750, the "Caring for an Aging America Act of 2009," a bill to provide for the establishment of a new geriatric and gerontology loan repayment program. Support all provisions. 3. S. 245/H.R. 468, the "Retooling the Health Care Workforce for an Aging America Act of 2009". This bill addresses the current and future shortage of health care personnel who are trained to care for older adults. Support all provisions. 4. S. 682, the "Mental Health on Campus Improvement Act," to amend the Public Health Service Act to improve mental and behavioral services on college campuses. Support all provisions. 5. S. 697, the "Community Living Assistance Supports and Services Act (CLASS Act)," to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment. Support all provisions. 6. H.R. 1457, the "Geriatrics Loan Forgiveness Act of 2009," to amend the Public Health Service Act to deem certain geriatric health training to be obligated service for purposes of the National Health Service Corps Loan Repayment Program, which provides up to $50,000 to repay student loans in exchange for working for two years in a high-need Health Professional Shortage Area. Support all provisions. 7. Discussed with House and Senate staff the need to include older adults in clinical trials. 8. Support involvement of geriatric specialists in development of medical homes. 9. Support patient privacy protections for health information systems. 10. Support comparative effectiveness research focused specifically on treatments for older adults and mental illness. 11. Support programs to reverse the declining numbers of geriatric specialists. 12. Oppose permitting age discrimination in insurance ratings in private or public health insurance systems. 13. Support legislation to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services. 14. Request Senate hearing to discuss opportunities within health reform to ameliorate and eliminate disparities in health status and health services. 15. H.R. 1932/S. 999, the "Child Health Care Crisis Relief Act," to address the national shortage of children's mental health professionals, including school-based professionals, by encouraging more individuals to enter these critical fields. 16. S. 678, "Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009". Support all provisions, but especially those that strengthen protections for those in the criminal and juvenile justices systems with needs related to mental health and substance abuse. 17. H.R. 2901, "Health Transitions Act," to provide access to knowledge, skills, and supports that are necessary for a successful transition to adulthood for young adults with mental health disorders. The bill would provide technical and monetary assistance to states as they implement plans to develop a coordinated service delivery system in order to maximize continuity of care and access to services. The bill would also establish planning and implementation grants to assist peer support programs and programs promoting independent living, life skills, employment, and education. 18. H.R. 1193, the "Federal Response to Eliminate Easting Disorders Act," to create Centers of Excellence dedicated to research collaboration, create a Center of Epidemiology to study the prevalence, economic impact and related morbidity and mortality rates of eating disorders, provide for evidence-based standards of care, establish education and prevention grant programs for training of health professionals and schools at all levels, provide public service announcements, and enhance access to care for those who suffer from easting disorders. 19. H.R. 2531, the "Mental Health in Schools Act of 2009," to authorize competitive grants to local school districts to assist them in early mental health interventions and referrals for treatment, to provide supports for students and their families, and to allow for staff training to be culturally and linguistically appropriate. 20. Support provisions in House and Senate draft health care reform bills to ensure coverage of critical services and supplies in a federal benefit standard and to require a fully open, transparent, and inclusive process for development of the standard that ensures full engagement of consumers, patients, workers and providers. 21. Support legislation to make mental health services for older adults an integral part of primary care services in community settings and to extend them to other settings where older adults reside and receive services.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1407: To amend title XVIII of the Social Security Act to reduce cost-sharing under Part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 534: A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutional full-benefit dual eligible individuals. S. 647: A bill to amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S. 1110: A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. S. 683: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. S. 46: A bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 1: Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes. H.R. 2: The Children's Health Insurance Program Reauthorization Act of 2009, establishing a Medicaid and CHIP Payment and Access Commission (MACPAC). This new Commission will provide Congress with a new, credible forum to discuss specific ways to strengthen the nation's Medicaid payment system, and ensure the growing needs of America's most vulnerable, frail, elderly and the disabled beneficiaries are met and in the years ahead. H.R. 2006: To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect and exploitation, and for ther purposes. H.R. 43: To amend title XVIII ofthe Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. H.R. 1255: A bill which protects the interests of each resident of intermediate care facilities for the mentally retarded or developmentally disabled (ICFs/MRDD) in related class action lawsuits. H.R. 448: Elder Abuse Victims ACt of 2009.

Client expense: $440,000 · Firm income: Not reported

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

S.478: A bill to amend the National Labor Relations Act, to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. S. 245 A bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States. S. 560: A bill to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during the organizing efforts, and for other purposes. S. 750: Caring for an Aging America Act. S. 245: Retooling the Health Care Workforce for an Aging Science Act of 2009. S. 750: A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R. 468: Retooling the Health Care Workforce for an Aging Science Act of 2009. H.R. 1409: To amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes. H.R. 1176: To amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board. H.R. 2536: A bill to provide relief for the shortage of nurses in the United States. H.R. 2223: To provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers.

Client expense: $440,000 · Firm income: Not reported

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

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

Client expense: $5,300,000 · Firm income: Not reported

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

S 697/HR 1721, Community Living Services and Supports Act - advocated in favor and for its inclusion in health care reform S 457/HR 3030, Fostering Independence Through Technology - provides incentives for home health care providers to use home monitoring and communications technologies - support S. 750, Caring for an Aging America Act, to attract and retain trained health care professionals and direct care workers to care for people as they age - support. S. 245/HR 468, Retooling the Healthcare Workforce for an Aging America Act: would expand opportunities for health care professionals at all levels to obtain education and training in geriatrics and gerontology - support and advocate for inclusion of its provisions in health care reform. HR 1642, Nursing Home Fire Safety Act, providing grants and loans to install automatic sprinklering systems in nursing homes - support.

Client expense: $169,773 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Universal Coverage. H.R. 15, H.R. 193, H.R. 676, H.R. 1200, S. 4: provisions providing health care or insurance for all U.S. residents and to control the cost and enhance the quality of the health care system. Importation of Prescription Drugs. H.R. 163, H.R. 1298, S. 525: provisions facilitating the importation of prescription drugs. Health Information Technology. H.R. 1031, H.R. 1039, S. 179, S. 444: provisions facilitating the adoption of modern information technology. Generic Drugs. S. 369: provision to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market. Long-Term Services and Supports. S. 697/H.R.1721: provisions providing assistance to individuals with functional impairments maintain their independence, authorizing establishment of a community living infrastructure, and providing assistance to family caregivers (CLASS Act). Healthcare Workforce. H.R. 468/S. 245, S. 750, H.R. 3098: provisions relating to the recruitment, training, and support of health care professionals and direct care workers in support of older Americans.

Client expense: $300,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

HR 1490, Social Worker Safety Act, issues relating to social work education. Issues relating to authorization of scholarship programs for health professionals at the Veterans Administration. Issues relating to child and family health/welfare programs as they relate to social work education. Issues relating to higher education, accountability and transparency. HR 2708, Indian Health Care Improvement Act, provisions relating to social work. S 252, Veterans Health Care Authorization Act, issues regarding scholarship programs and VA social work workforce needs. HR 1457, Geriatrics Loan Forgiveness Act, issues pertaining to social work, education and training. HR 1928, Home Healthcare Nurse Promotion Act, provisions pertaining to loan forgiveness. Positive Aging Act of 2009, all provisions relating to mental health services. HR 2410, Paul Simon Study Abroad Foundation Act, issues pertaining to study abroad opportunities for students. HR 1777, Higher Education Technical Amendments, issues pertaining to student aid. HR 795/S688, Drothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act, all provisions. HR 468/S245, Retooling the Health Care Workforce for an Aging America Act, Title I, Subtitle A, provisions pertaining to social work, education and training programs. HR 1361/S538, Increased Student Achievement through Licensed Student Support Act, all provisions. HR 1932/S999, Child Health Care Crisis Relief Act, all provisions pertaining to education and training. S 750, Caring for an Aging America Act, all provisions pertaining to education and training. HR 7302/S 3708 (110th Congress), Health Professions and Primary Care Reinvestment Act, Section 9, provisions pertaining to education and training.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, SENATE, Veterans Affairs, Dept of (VA)