Family Economic Success Act

Federal challenges and opportunities for Missouri hospitals, generally; Oppose legislative and executive branch proposals to restrict states' use of provider taxes to fund their Medicaid programs; Provider tax restrictions included in the Obama Administration's 10-year deficit reduction proposal; Support for eliminating the current "sustainable growth rate" formula used to set Medicare physician fees and replacing it without reducing hospital payments to offset the cost of doing so; Support for repealing a section of the Patient Protection and Affordable Care Act of 2010 that changed the budget neutrality test for the changes in the "rural floor" component of the Medicare Average Wage Index calculations; Support for legislation that prevents federal Medicare contractors form recalculating lower Medicare payments to critical access hospitals; Deficit reduction legislation, generally; Missouri hospitals' economic contributions, including actual and projected Medicare margins for Missouri hospitals; Support for access to physician services in rural Missouri; and Support for maintaining hospital payments for critical access, sole community and Medicare-dependent hospitals. CMS' survey and certification issues. HRSA's Office of Rural Health Programs AHRQ's MONAHRQ program for presenting health care quality data. Use of provider taxes to fund Medicaid programs. Proposed cuts in payments for graduate medical education. Oppose restrictions on states' use of provider taxes. Promote the elimination or restrictions on Medicare payments for bad debt expenses, cuts in graduate medical education payments and the consolidation of Medicaid matching fund rates. Coding offset included in the agency's proposed regulatory changes to the Medicare prospective payment system. Legislative provisions that were codified in the Budget Control Act of 2011. The repeal of a section of the Patient Protection and Affordable Care Act of 2010 that changed the budget neutrality test for the changes in the "rural floor" component of the Medicare Average Wage Index calculations. National Labor Relations Board's regulations on the posting of notices of workers' rights to engage in collective bargaining Issues related to Missouri's reliance on provider taxes to fund its Medicaid program.

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

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

-Distributed a letter to the Missouri congressional delegation expressing opposition to legislative and executive branch proposals to restrict states' use of provider taxes to fund their Medicaid programs. -Contacted each office of the Missouri congressional delegation regarding endorsement of a letter to President Obama expressing opposition to executive branch proposals to restrict states' use of provider taxes to fund their Medicaid programs. -Contacted various offices of the Missouri congressional delegation to provide information regarding the use of provider taxes to fund Medicaid programs. -The Missouri Hospital Association, the Missouri Health Care Association and the Leading Age Missouri sent a joint letter to the Missouri congressional delegation on restrictions on states' use of provider taxes. -The Missouri Hospital Association and the Missouri State Medical Association sent a joint letter to the Missouri congressional delegation regarding proposed cuts in payments for graduate medical education. -Met with staff members and legislators from each office of the Missouri congressional delegation to discuss restrictions on states' use of provider taxes. Other topics included elimination or restrictions on Medicare payments for bad debt expenses, cuts in graduate medical education payments and the consolidation of Medicaid matching fund rates. -Contacted the Missouri congressional delegation to encourage them to sign a House or Senate "Dear Colleague" letter to CMS regarding the coding offset included in the agency's proposed regulatory changes to the Medicare prospective payment system. -Contacted selected members of the Missouri congressional delegation regarding the legislation that was codified in the Budget Control Act of 2011. -Expressed support for repealing a section of the Patient Protection and Affordable Care Act of 2010 that changed the budget neutrality test for the changes in the "rural floor" component of the Medicare Average Wage Index calculations. -Responded to a House committee staff query regarding a potential witness to testify at a hearing regarding the National Labor Relations Board's regulations on the posting of notices of workers' rights to engage in collective bargaining. -Contacted congressional staff regarding a Washington, D.C., briefing on the topic of Missouri's reliance on provider taxes to fund its Medicaid program. -Responded to a congressional staff member query about attending the Missouri Hospital Association's annual convention and trade show. -Expressed concern about the provider tax restrictions included in the Obama Administration's 10-year deficit reduction proposal. -Met with the Missouri congressional delegation to discuss the following topics: 1) a listing of federal challenges and opportunities for Missouri hospitals; 2) opposition to restrictions on states' use of provider taxes; 3) support for eliminating the current "sustainable growth rate" formula used to set Medicare physician fees and replacing it without reducing hospital payments to offset the cost of doing so; 4) support for repealing a section of the Patient Protection and Affordable Care Act of 2010 that changed the budget neutrality test for the changes in the "rural floor" component of the Medicare Average Wage Index calculations; support for legislation that prevents federal Medicare contractors form recalculating lower Medicare payments to critical access hospitals; (5) deficit reduction legislation; (6) Missouri hospitals' economic contributions; (7) actual and projected Medicare margins for Missouri hospitals; (8) access to physician services in rural Missouri; and 9) support for maintaining hospital payments for critical access, sole community and Medicare-dependent hospitals. -Met with regional CMS officials to discuss survey and certification issues. -Discussed the programs of HRSA's Office of Rural Health with its staff. -Discussed with AHRQ staff the agency's MONAHRQ program for presenting health care quality data.

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

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

H.R. 283, Living American Wage Act--federal minimum wage provisions H.R. 631, WAGES Act--federal minimum wage and tip credit provisions S. 10, Family Economic Success Act--minimum wage provisions S. 797, to amend the FLSA regarding remedies for victims of discrimination in the payment of wages S. 984, the Healthy Families Act--provisions relating to paid sick leave H.R. 1876, regarding paid sick time--provisions relating to paid sick leave H.R. 1519, Paycheck Fairness Act--provisions relating to discrimination in payment of wages H.R. 1440, Family and Medical Leave Enhancement Act--provisions relating to expansion of employer FMLA mandates

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE