Medicare Patient Access to Physical Therapists Act of 2009

Issues related to water rights settlement S.950 - Technical Correction to the Shoshone-Paiute Tribes of the Duck Valley Reservation Water Rights Settlement Act H.R.1738 - To amend the Omnibus Public Land Management Act of 2009 to make a technical correction to the water rights settlement for the Shoshone-Paiute Tribes of the Duck Valley Reservation, and for other purposes. Issues related to BIA contamination of ground water on the tribe's reservation.

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

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Interior, Dept of (DOI), SENATE

Issues related to water rights settlement S.950 - Technical Correction to the Shoshone-Paiute Tribes of the Duck Valley Reservation Water Rights Settlement Act H.R.1738 - To amend the Omnibus Public Land Management Act of 2009 to make a technical correction to the water rights settlement for the Shoshone-Paiute Tribes of the Duck Valley Reservation, and for other purposes. Issues related to BIA contamination of ground water on the tribes reservation

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

Government targets: HOUSE OF REPRESENTATIVES, Interior, Dept of (DOI), SENATE

Issues related to water rights settlement S.950 - Technical Correction to the Shoshone-Paiute Tribes of the Duck Valley Reservation Water Rights Settlement Act H.R.1738 - To amend the Omnibus Public Land Management Act of 2009 to make a technical correction to the water rights settlement for the Shoshone-Paiute Tribes of the Duck Valley Reservation, and for other purposes. Issues related to BIA contamination of ground water on the tribes reservation

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

Government targets: HOUSE OF REPRESENTATIVES, Interior, Dept of (DOI), SENATE

Issues related to water rights settlement S.950 - Technical Correction to the Shoshone-Paiute Tribes of the Duck Valley Reservation Water Rights Settlement Act H.R.1738 - To amend the Omnibus Public Land Management Act of 2009 to make a technical correction to the water rights settlement for the Shoshone-Paiute Tribes of the Duck Valley Reservation, and for other purposes. Issues related to BIA contamination of ground water on the tribes reservation

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

Government targets: HOUSE OF REPRESENTATIVES, Interior, Dept of (DOI), SENATE

H.R. 1829/S.950- Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 3693- Ensuring the Future Physician Workforce Act of 2009 H.R. 4851-Continuing Extension Act 2010H.J. RES 45- Increasing the statutory limit on the public debt H.R. 3962- Affordable Health Care for American Act H.R. 3962-The Presevation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3961-Medicare Physician Payment Reform Act of 2009 H.R. 4985- Medicare Decisions Accountability Act of 2010 H.R. 4872- Health Care and Education Reconciliation Act of 2010 H.R. 3590-Partient Protection and Affordable Care Act H.R. 1031-Health Information Technology Promotion Act of 2009 H.R. 1911- American Recovery & Reinvestment Act (ARRA) Health Information Technology Meaningful Use StarkII- Physician Ban on Self-referral and Other Fraud & Abuse: ensure the Stark laws do not prevent timely access to quality medical services. Surgical Workforce Shortage

Client expense: $286,383 · Firm income: Not reported

Monitored and lobbied upon entire bills of the following: H.R.531, the Access to Frontline Health Care Act of 2011 H.R.1546 / S.829, Medicare Access to Rehabilitation Services Act of 2011; repeal of the Therapy Cap on Outpatient Rehabilitation Services The Medicare Patient Access to Physical Therapists Act (no bill number, formerly H.R.1829 / S.950); to improve access to physical therapists for Medicare beneficiaries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitored and lobbied upon entire bills of the following: H.R.531, the Access to Frontline Health Care Act of 2011 H.R.1546 / S.829, Medicare Access to Rehabilitation Services Act of 2011; repeal of the Therapy Cap on Outpatient Rehabilitation Services The Medicare Patient Access to Physical Therapists Act (no bill number, formerly H.R.1829 / S.950); to improve access to physical therapists for Medicare beneficiaries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 3693 - Ensuring the Future Physican Workforce Act of 2009 H.R. 4851 - Continuing Extension Act of 2010 H.J. RES. 45 - Increasing the statutory limit on the public debt H.R. 3962 - Affordable Health Care for America Act H.R. 3962 - The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3961 - Medicare Physician Payment Reform Act of 2009 H.R. 4985 - Medicare Decisions Accountability Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 1031 - Health Information Technology Promotion Act of 2009 H.R. 1911 - American Recovery & Reinvestment Act (ARRA) Health Information Technology Meaningful Use Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services. Surgical Workforce Shortage

Client expense: $286,383 · Firm income: Not reported

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 3693 - Ensuring the Future Physican Workforce Act of 2009 H.R. 4851 - Continuing Extension Act of 2010 H.J. RES. 45 - Increasing the statutory limit on the public debt H.R. 3962 - Affordable Health Care for America Act H.R. 3962 - The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3961 - Medicare Physician Payment Reform Act of 2009 H.R. 4985 - Medicare Decisions Accountability Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 1031 - Health Information Technology Promotion Act of 2009 H.R. 1911 - American Recovery & Reinvestment Act (ARRA) Health Information Technology Meaningful Use Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services. Surgical Workforce Shortage

Client expense: $331,937 · Firm income: Not reported

Monitored and lobbied upon entire bills of the following: H.R.531, the Access to Frontline Health Care Act of 2011 H.R.1546 / S.829: Medicare Access to Rehabilitation Services Act of 2011; repeal of the Therapy Cap on Outpatient Rehabilitation Services The Medicare Patient Access to Physical Therapists Act (no bill number, formerly H.R.1829 / S.950); to improve access to physical therapists for Medicare beneficiaries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 3693 - Ensuring the Future Physican Workforce Act of 2009 H.R. 4851 - Continuing Extension Act of 2010 H.J. RES. 45 - Increasing the statutory limit on the public debt H.R. 3962 - Affordable Health Care for America Act H.R. 3962 - The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3961 - Medicare Physician Payment Reform Act of 2009 H.R. 4985 - Medicare Decisions Accountability Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 1031 - Health Information Technology Promotion Act of 2009 H.R. 1911 - American Recovery & Reinvestment Act (ARRA) Health Information Technology Meaningful Use Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services. Surgical Workforce Shortage

Client expense: $352,625 · Firm income: Not reported

Monitored and lobbied upon entire bills of the following: H.R.531, the Access to Frontline Health Care Act of 2011 The Medicare Access to Rehabilitation Services Act (no bill number, formerly H.R.43 / S.46); repeal of the Therapy Cap on Outpatient Rehabilitation Services The Medicare Patient Access to Physical Therapists Act (no bill number, formerly H.R.1829 / S.950); to improve access to physical therapists for Medicare beneficiaries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094/S 3978 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. Also Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1137 - Athletic Trainers Access to Medicare Act - opposed PL 111-152 - Reconciliation Act of 2010 - implentation as it relates to occupational therapy. HR 5712 - Physician Payment and Therapy Relief Act: advocated to reduce impact on occupational therapy for Medicare payment policy changes. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services. No bill: Advocate to Congress and Centers for Medicare/Medicaid Services (CMS) to oppose proposed Multiple Procedure Payment Reductions, cuts to therapy reimbursement in the proposed 2011 Medicare Physician Fee Schedule rule. CMS staff: Marilyn Tavenner, Principal Deputy Administrator and Johnathan Bluhm, Director of Center for Medicare Management HR 1586 - Education and Medicaid Funding for States: Supported passage. HR 4994 - Medicare and Medicaid Extenders Act: advocated for therapy cap exceptions process extension through 2011 and advocated related to RUGS-IV implementation.

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 Opt-Out Locum Tenens Consumer Financial Protection Bureau Authority over Health Care Providers/Physical Therapy H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act Repeal of 1099 Tax Filing Requirement S. 3987 Red Flag Program Clarification Act

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

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis of the Inpatient Rehabilitation Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues-HHPPS Proposed Rule 2011, SNF Updates 2011 Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries. Medicare SNF PPS FY 2010 Medicare IRF PPS FY 2010 Medicare Home Health PPS CY 2010 H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services. H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4851-Continuing Extension Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 H.R. 4662- Lymphedema Diagnosis and Treatment Cost Saving Act of 2010 H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act 2011 Medicare Physician Fee Schedule Proposed Rule Health Care Truth and Transparency Legislative Recommendations for Medicaid & CHIP- RFI June 2010 MedPAC Report to Congress-Aligning Incentives in Medicare H.R. 2575/S.3220 -Prosthetic and Custom Orthotic Parity Act of 2009 H.R. 2479- Medicare Orthotics and Prosthetics Improvement Act of 2009 HIT Rules- Meaningful Use Health Exchanges Proposed Rule Multiple Procedure Payment Reduction In Office Ancillary Services/Self Referral Annual Wellness Visit Rule Extension of Federal Medical Assistance Percentages H.R. 4994- the Medicare and Medicaid Extenders Act H.R. 5712- the Physician Payment and Therapy Relief Act of 2010 Comments on Physician Compare Federal External Review Process Comments

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 3693 - Ensuring the Future Physican Workforce Act of 2009 H.R. 4851 - Continuing Extension Act of 2010 H.J. RES. 45 - Increasing the statutory limit on the public debt H.R. 3962 - Affordable Health Care for America Act H.R. 3962 - The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3961 - Medicare Physician Payment Reform Act of 2009 H.R. 4985 - Medicare Decisions Accountability Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 1031 - Health Information Technology Promotion Act of 2009 H.R. 1911 - American Recovery & Reinvestment Act (ARRA) Health Information Technology Meaningful Use Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services. Surgical Workforce Shortage

Client expense: $573,687 · Firm income: Not reported

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services. No bill: Advocate to Congress and Centers for Medicare/Medicaid Services (CMS) to oppose proposed Medicare Physician Payment Reductions, cuts to therapy reimbursement in the proposed 2011 Medicare Physician Fee Schedule rule. CMS staff: Marilyn Tavenner, Principal Deputy Administrator and Johnathan Bluhm, Director of Center for Medicare Management HR 1586 - Education and Medicaid Funding for States: Supported passage.

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis of the Inpatient Rehabilitation Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries. Medicare SNF PPS FY 2010 Medicare IRF PPS FY 2010 Medicare Home Health PPS CY 2010 H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services. H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4851-Continuing Extension Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 H.R. 4662- Lymphedema Diagnosis and Treatment Cost Saving Act of 2010 H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act 2011 Medicare Physician Fee Schedule Proposed Rule Health Care Truth and Transparency June 2010 Medpac Report to Congress-Aligning Incentives in Medicare H.R. 2575/S.3220 -Prosthetic and Custom Orthotic Parity Act of 2009 H.R. 2479- Medicare Orthotics and Prosthetics Improvement Act of 2009

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 Opt-Out Locum Tenens Consumer Financial Protection Bureau Authority over Health Care Providers/Physical Therapy H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act

Client expense: $280,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 Opt-Out Locum Tenens Consumer Financial Protection Bureau Authority over Health Care Providers/Physical Therapy H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act Repeal of 1099 Tax Filing Requirement

Client expense: $310,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis of the Inpatient Rehabilitation Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues-HHPPS Proposed Rule 2011, SNF Updates 2011 Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries. Medicare SNF PPS FY 2010 Medicare IRF PPS FY 2010 Medicare Home Health PPS CY 2010 H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services. H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4851-Continuing Extension Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 H.R. 4662- Lymphedema Diagnosis and Treatment Cost Saving Act of 2010 H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act 2011 Medicare Physician Fee Schedule Proposed Rule Health Care Truth and Transparency Legislative Recommendations for Medicaid & CHIP- RFI June 2010 Medpac Report to Congress-Aligning Incentives in Medicare H.R. 2575/S.3220 -Prosthetic and Custom Orthotic Parity Act of 2009 H.R. 2479- Medicare Orthotics and Prosthetics Improvement Act of 2009 HIT Rules- Meaningful Use Health Exchanges Proposed Rule Multiple Procedure Payment Reduction In Office Ancillary Services Annual Wellness Visit Rule Extension of Federal Medical Assistance Percentages

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 3693 - Ensuring the Future Physican Workforce Act of 2009 H.R. 4851 - Continuing Extension Act of 2010 H.J. RES. 45 - Increasing the statutory limit on the public debt H.R. 3962 - Affordable Health Care for America Act H.R. 3962 - The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3961 - Medicare Physician Payment Reform Act of 2009 H.R. 4985 - Medicare Decisions Accountability Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 1031 - Health Information Technology Promotion Act of 2009 H.R. 1911 - American Recovery & Reinvestment Act (ARRA) Health Information Technology Meaningful Use Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services. Surgical Workforce Shortage

Client expense: $439,000 · Firm income: Not reported

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis of the Inpatient Rehabilitation Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries. Medicare SNF PPS FY 2010 Medicare IRF PPS FY 2010 Medicare Home Health PPS CY 2010 H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services. H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4851-Continuing Extension Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 H.R. 4662- Lymphedema Diagnosis and Treatment Cost Saving Act of 2010 H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act 2011 Medicare Physician Fee Schedule Proposed Rule Health Care Truth and Transparency June 2010 Medpac Report to Congress-Aligning Incentives in Medicare H.R. 2575/S.3220 -Prosthetic and Custom Orthotic Parity Act of 2009 H.R. 2479- Medicare Orthotics and Prosthetics Improvement Act of 2009

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 Opt-Out Locum Tenens Consumer Financial Protection Bureau Authority over Health Care Providers/Physical Therapy H.R. 4213- American Jobs, Closing Loopholes and Preventing Outsourcing Act H.R. 3962- Preservation of Access to Care for Medicare Beneficiaries & Pension Relief Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR4691 (PL 111-144) - Temporary Extensions Act of 2010: Advocate for extension of Medicare Therapy Caps Exceptions process and the Medicare Physicians Payment Update. HR 4851 (PL 111-157) - Continuing Extension Act of 2010: Advocate for extension of Medicare Physicians Payment Update. HR 3692 (PL 111-192) - Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010: Advocated for extension of Medicare Physicians Payment Update. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services.

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act H.R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis of the Inpatient Rehabilitation Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries. Medicare SNF PPS FY 2010 Medicare IRF PPS FY 2010 Medicare Home Health PPS CY 2010 H.R. 3962 Affordable Health Care Act for America H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services. H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 H.R. 4662- Lymphedema Diagnosis and Treatment Cost Saving Act of 2010

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 Opt-Out Locum Tenens

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 Opt-Out Locum Tenens

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act H.R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis of the Inpatient Rehabilitation Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries. Medicare SNF PPS FY 2010 Medicare IRF PPS FY 2010 Medicare Home Health PPS CY 2010 H.R. 3962 Affordable Health Care Act for America H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services. H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 H.R. 4662- Lymphedema Diagnosis and Treatment Cost Saving Act of 2010

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 3693 - Ensuring the Future Physican Workforce Act of 2009 H.R. 4851 - Continuing Extension Act of 2010 H.J. RES. 45 - Increasing the statutory limit on the public debt H.R. 3962 - Affordable Health Care for America Act H.R. 3961 - Medicare Physician Payment Reform Act of 2009 H.R. 4985 - Medicare Decisions Accountability Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 1031 - Health Information Technology Promotion Act of 2009 H.R. 1911 - American Recovery & Reinvestment Act (ARRA) Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services. Surgical Workforce Shortage

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

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. S. 1679 - Affordable Health Choices Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and support of efforts to address shortages in health care workforce, including occupational therapy.. S. 1796 - America's Healthy Future Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR4691 (PL 111-144) - Temporary Extensions Act of 2010: Advocate for extension of Medicare Therapy Caps Exceptions process and the Medicare Physicians Payment Update. HR 4851 (PL 111-157) - Continuing Extension Act of 2010: Advocate for extension of Medicare Physicians Payment Update.

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 Opt-Out Locum Tenens

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act H.R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis of the Inpatient Rehabilitation Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries. Medicare SNF PPS FY 2010 Medicare IRF PPS FY 2010 Medicare Home Health PPS CY 2010 H.R. 3962 Affordable Health Care Act for America H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services. H.R. 4872- Health Care & Education Affordability Reconciliation Act H.R. 4691-Temporary Extension Act of 2010 H.R. 4851-Continuing Extension Act of 2010 H.R. 4231-Tax Extenders Act of 2010 H.R. 4154- American Workers State and Business Relief Act of 2010 H.R. 4662- Lymphedema Diagnosis and Treatment Cost Saving Act of 2010

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 1031 - Health Information Technology Promotion Act of 2009: ensure investments in health to produce interoperable and compatible systems/programs. H.R. 1911 - American Recovery & Reinvestment Act (ARRA): funding to help award recipients defray the cost of data collection re quirements initiated pursuant to such Act, and for other purposes. Practice Expense Payment Under Medicare: ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Payment of Teaching Physicians Under Medicare: ensure that physicians who teach future healers are adequately reimbursed. Payment of Graduate Medical Education Under Medicare: promote ample/adequate federal assistance to individuals enrolled in medical school who can afford the cost. Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services.

Client expense: $620,000 · Firm income: Not reported

S.46/H.R.43: Medicare Access to Rehabilitation Services Act of 2009 S.950/H.R. 1829: Medicare Patient Access to Physical Therapists Act of 2009 Comprehensive Health Reform H.R. 3200: America's Affordable Health Choices Act of 2009 America's healthy Future Act S. 1679: The Affordable Health Choices Act &HR 4314 Continued Government Financing Act H.R. 3590: Patient Protection and Affordable Care Act H.R. 3962 Affordable Health Care for America Act H.R. 4314: Continued Government Financing Act

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

S.46/H.R.43: Medicare Access to Rehabilitation Services Act of 2009 S.950/H.R. 1829: Medicare Patient Access to Physical Therapists Act of 2009 Comprehensive Health Reform H.R. 3200: America's Affordable Health Choices Act of 2009 America's healthy Future Act S. 1679: The Affordable Health Choices Act &HR 4314 Continued Government Financing Act H.R. 3590: Patient Protection and Affordable Care Act H.R. 3962 Affordable Health Care for America Act

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

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 1031 - Health Information Technology Promotion Act of 2009: ensure investments in health to produce interoperable and compatible systems/programs. H.R. 1911 - American Recovery & Reinvestment Act (ARRA): funding to help award recipients defray the cost of data collection re quirements initiated pursuant to such Act, and for other purposes. Practice Expense Payment Under Medicare: ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Payment of Teaching Physicians Under Medicare: ensure that physicians who teach future healers are adequately reimbursed. Payment of Graduate Medical Education Under Medicare: promote ample/adequate federal assistance to individuals enrolled in medical school who can afford the cost. Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services.

Client expense: $560,000 · Firm income: Not reported

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. S. 1679 - Affordable Health Choices Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and support of efforts to address shortages in health care workforce, including occupational therapy.. S. 1796 - America's Healthy Future Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy.

H.R. 3854- Small Business Financing and Investment Act H.R. 43/S. 46- Medicare Access to Rehabilitation Services Act of 2009 H.R. 3962- Affordable Health Care Act for America H.R. 3590- Patient Protection and Affordable Care Act Non-discrimination Physician Practice Information Survey Red Flag Rules H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009

Client expense: $210,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act H.R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures (comments) Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Implementation of the classification criteria for inpatient rehab facilities known as the 60 percent rule (comments) Home Health assessment instrument known as OASIS C (comments) Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis and Alternatives to the Inpatient Rehabilitation 60 percent rule (recommendations) Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup), development of short-term alternatives Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules- Definition of Outpatient Hospital Services Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries in rural areas. Medicare SNF PPS FY 2010 Proposed Rule (comments) Medicare IRF PPS FY 2010 Proposed Rule (comments) Medicare Home Health PPS CY 2010 Proposed rule (comments) Health Information Technology H.R. 3962 Affordable Health Care Act for America H.R. 3590 Patient Protection and Affordable Care Act Physician Practice Information Survey (PPIS) H.R. 4371- To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services.

Medicare Physician Payment Reform. CMS Transmittals - 84,1470 and 1550 - "Incident to" policy relating to audiology services. H.R. 3024 - Medicare Hearing Healthcare Enhancement Act of 2009; all provisions. H.R. 2718 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009; all provisions H.R. 2844 - Medicare Payment Improvement Act of 2009; all provisions. S. 1110 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009; all provisions. S. 950 Medicare Patient Access to Physical Therapists Act of 2009; all provisions. S. 1776 - Medicare Physician Fairness Act of 2009; all provisions H.R. 3961 - Medicare Physician Payment Reform Act of 2009; all provisions. H.R. 4371 - To amend title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services.

Client expense: $124,976 · Firm income: Not reported

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

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068- Medicare Telehealth .Expansion Act of 2009: advocated for passage HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy.

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

H.R. 1829/S.950 - Medicare Patient Access to Physical Therapists Act of 2009: prevent direct access to physical therapists in order to avoid unnecessary and overuse of therapy services. H.R. 1031 - Health Information Technology Promotion Act of 2009: ensure investments in health to produce interoperable and compatible systems/programs. H.R. 1911 - American Recovery & Reinvestment Act (ARRA): funding to help award recipients defray the cost of data collection re quirements initiated pursuant to such Act, and for other purposes. Practice Expense Payment Under Medicare: ensure awareness for the rising cost of practice expenses and the levels paid through Medicare. Payment of Teaching Physicians Under Medicare: ensure that physicians who teach future healers are adequately reimbursed. Payment of Graduate Medical Education Under Medicare: promote ample/adequate federal assistance to individuals enrolled in medical school who can afford the cost. Stark II - Physician Ban on Self-Referral and Other Fraud & Abuse: ensure that Stark laws do not prevent timely access to quality medical services.

Client expense: $320,000 · Firm income: Not reported

H.R. 43/S.46 - Medicare Access to Rehabilitation Services Act of 2009 H.R. 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009 H.R. 1829/ S. 950 - Medicare Patient Access to Physical Therapists Act of 2009 H.R. 1430 - The Medicare Oral Health Rehabilitative Enhancement Act H.R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 Revisions to the home health assessment instrument OASIS National Quality Forum home health quality measures (comments) Cardiac and Pulmonary Rehab national coverage policies AHRQ technical assessment of negative pressure wound therapy devices Implementation of the classification criteria for inpatient rehab facilities known as the 75 percent rule (comments) Home Health assessment instrument known as OASIS C (comments) National Coverage Determination regarding pulmonary rehab and expansion of a current national coverage determination on Cardiac Rehab (comments) Comprehensive assessment regarding the development of HCPCS codes for negative pressure wound therapy (sign on) Analysis and Alternatives to the Inpatient Rehabilitation 75 percent rule (recommendations) Condition of Participation (COP) on rehab agencies Importance of support personnel and related services under IDEA and ESEA. Development of a Plan to Transition to a Medicare Value-Based Purchasing (VBP) Program for Physician and Other Professional Services Issues Paper (comments) Changes to Medicare payment policies (STATS workgroup) Section 427 of Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) Quality Measures Medically Unbelievable Edits (comments) DMEPOS Accreditation AMA Physician Consortium for Performance Improvement EMG performance Physical Medicine and Rehabilitation LCD (comments) Physician Quality Reporting Initiative Provider Enrollment Post Acute Care Issues Post Acute Care Payment Reform Demonstration, including development and testing of CARE tool Development of long term alternatives to the therapy cap - "Developing Outpatient Therapy Alternatives Project" (DOTPA) Medicare Orthotics and Prosthetics Physician Fee Schedule Update Sustainable Growth Rate (SGR) Inpatient Rehab Issues Medicaid Rules- Definition of Outpatient Hospital Services Self Referral H.R. 1094- The Medicare Home Health Flexibility Act Inclusion of Physical Therapists in the Medicare & Medicaid Health Information Technology incentives S. 1213- Patient Centered Outcomes Research Act of 2009 H.R. 2068- Medicare Telehealth Enhancement Act of 2009 H.R. 1094- Medicare Home Health Flexibility Act The Addition of a program to the Center for Medicare Services Innovation Center to research direct access models for expanding access to physical therapy for Medicare beneficiaries in rural areas. Medicare SNF PPS FY 2010 Proposed Rule (comments) Medicare IRF PPS FY 2010 Proposed Rule (comments) Medicare Home Health PPS CY 2010 Proposed rule (comments)

S.46/H.R.43: Medicare Access to Rehabilitation Services Act of 2009 S.950/H.R.1829: Medicare Patient Access to Physical Therapists Act of 2009 Comprehensive Health Reform H.R.3200: America's Affordable Health Choices Act of 2009 Americas Healthy Future Act S.1679: The Affordable Health Choices Act

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

Medicare Physician Payment Reform. CMS Transmittals - 84,1470, and 1550 - "Incident to" policy relating to audiology services. H.R. 3024- Medicare Hearing Health Care Enhancement Act of 2009, all provisions. H.R. 2718- Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, all provisions. H.R. 2844- Medicare Payment Improvement Act of 2009, all provisions. S. 1110 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, all provisions. S. 950 - Medicare Patient Access to Physical Therapists Act of 2009, all provisions.

Client expense: $122,125 · Firm income: Not reported

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