Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011

Legislation and issues relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); Nurse Education, Expansion, and Development Act; Nursing provisions in potential job creation legislation; Negotiated Rulemaking on Designation of Medically Underserved and Health Professional Shortage Areas; Administration review of current regulations; Prevention and Public Health Fund; Definition of essential health benefits; Health information technology and electronic health records; HRSA nurse practitioner national sample survey; Amendments to the Consumer Product Safety Improvement Act; Menu and Nutrition Labeling; Draft legislation to reauthorize the Prescription Drug User Fee Act (PDUFA); Draft legislation on Congressional Budget Office scoring of preventive health services; Draft legislation on voluntary tandem licensing and credentialing for federal telemedicine services; Draft legislation on reauthorization of the National Quality Forum; H.R. 5/S. 218/S. 1099 - Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act; H.R. 5 - Protecting Access to Healthcare (PATH) Act; H.R. 451 - Healthcare Truth and Transparency Act of 2011; S. 248/H.R. 844 - Empowering States to Innovate Act; S. 174 - Healthy Lifestyles and Prevention Act; H.R. 10/S. 299/S. 1720/S. 1786 - Regulations From the Executive in Need of Scrutiny (REINS) Act; H.R. 1217 - to repeal the Prevention and Public Health Fund; H.R. 1683/S. 868 - State Flexibility Act; H.R. 2465 - Federal Workers' Compensation Modernization and Improvement Act; S. 261 - Federal Employees' Compensation Reform Act; H.R. 469 - Protecting Student Athletes from Concussions Act; S. 601/H.R. 1127 - Childrens Sports Athletic Equipment Safety Act; Concussion Treatment and Care Tools (ConTACT) Act; S. 54 - Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act; S. 55 - Nursing School Clinics Act; H.R. 157 - Health Care Safety Net Enhancement Act; H.R. 227 - Child Gun Safety and Gun Access Prevention Act; H.R. 338 - Protecting Our Kids' Medicine Act; H.R. 469 - Protecting Student Athletes from Concussions Act; H.R. 576 - Healthy Children Through School Nutrition Education Act; H.R. 713 - Keeping Families Together Act; H.R. 751 - Mental Health in Schools Act; H.R. 1214 - to repeal mandatory funding for school-based health center construction; S. 961 - Reconnecting Youth to Prevent Homelessness Act; S. 1165, Button Cell Battery Safety Act. H.R. 1852/S. 958 - Childrens Hospital GME Support Reauthorization Act; H.R. 115 - CHAMPVA Childrens Protection Act; H.R. 364 - Common Sense Health Reform Americans Actually Want Act; H.R. 614 - Post 9/11 G.I. Bill Dependent Coverage Improvement Act; H.R. 978 - Seniors Identity Protection Act; H.R. 989 - Voluntary State Discount Prescription Drug Plan Act; H.R. 1035/S. 1504 - Medicaid Coverage for Citizens of Freely Associated States Act; H.R. 2029/S. 1131 - Birth Defects Prevention, Risk Reduction, and Awareness Act; H.R. 2758/S. 1463 - Breastfeeding Promotion Act; H.R. 2229 - Student-to-School Nurse Ratio Improvement Act. H.R. 3679 - National Nurse Act; H.R. 4274 - BPCA and PREA Reauthorization Act; S. 2289 - Better Pharmaceuticals and Devices for Children Act; H.R. 5651 - Food and Drug Administration Reform Act; H.R. 5842 - Restoring Access to Medication Act; S. 3187 - FDA Safety and Innovation Act S. 2474 - Health Equity and Accountability Act; S. 1789 - 21st Century Postal Service Act; S. 847 - Safe Chemicals Act; H.R. 2405/S. 1855/H.R. 6672 - Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; H.R. 2359 - Safe Cosmetics Act; H.R. 6482 - Preventive Health Savings Act; Supplemental Nutrition Assistance Program (SNAP) provisions of H.R. 6083, Federal Agriculture Reform and Risk Management (FARRM) Act, and S.3240, Agriculture Reform, Food, and Jobs Act; H.R. 5647/S. 3565 - Pregnant Workers Fairness Act.

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

S. 20/H.R. 1744 American Job Protection Act; Affordable Care Act, all provisions, including employer penalities, essential health benefits, exchanges, age rate band compression; Health Care Reform; Health Care Mandate Penalties; Employer/Employee Flexibility; Consumer-Directed Health Care; Health Insurance Exchanges; Medicare Secondary Payer Judgments; Comments on FDA's Suggested Questions & Answers for the Final Patient Protection & Affordable Care Act Section 4205 Guidance; Comments on IRS' "Shared Responsibility for Employers Regargding Health Care Coverage (IRC Sec. 1513)"; H.R.1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, all provisions; H.R.2077, MLR Repeal Act of 2011, all provisions; S.1098, Family and Retirement Health Investment Act of 2011, all provisions; H.R.5/S.1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, all provisions; H.R.1206, Access to Professional Health Insurance Advisors Act of 2011, all provisions; Summary of Benefit NRPM; Comments regarding employer interactions with insurance exchanges, health premium tax credits, and development of an affordability safe harbor for employers; S.1880, Jobs and Premium Protection Act, all provisions; S.1049/H.R. 2676, Small Business Health Relief Act of 2011, all provisions; H.R.2206, Auto Enroll Repeal Act, all provisions..

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Motor Carrier Safety Administration, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson, H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson, H.R.611 -- BEST PRACTICES Act (Rush) - data security, H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information, H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians, H.R. 1707, Data Accountability and Trust Act (Rush) - data security, H.R. 1841, Data Accountability and Trust Act (Stearns) - data security, H.R. 2576, (Black) - eligibility for health care assistance, H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security, H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions, H.R. 4310, National Defense Authorization Act (McKeon) - TRICARE provisions, H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency, H.R. 5817, Eliminate Privacy Notice Confusion Act (Luetkemeyer) - privacy, H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services, H.R. 6684, Spending Reduction Act (Ryan) - ACA provisions, deficit reduction proposals, H.J.Res. 17, Continuing Appropriations Resolution (Rogers) - temporary appropriations for FY 2013, S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions, S. 1099, HEALTH Act (Blunt) - medical liability reform, S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security, S. 1207, Data Security and Breach Notification Act (Pryor) - data security, S. 1223, Location Privacy Protection Act (Franken) - privacy, S. 1408, Data Breach Notification Act (Feinstein) - data security, S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security, S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees, S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy, S. 3254, National Defense Authorization Act (Levin) - TRICARE provisions, S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services, S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments, S. 3333, Data Security and Breach Notification Act (Toomey) - data security, S. 3351, Protect Our Health Privacy Act (Franken) - privacy, S. 3414, Cybersecurity Act (Lieberman) - privacy, data security, S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) - privacy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 and HR 2245 Preserving Access to Life-Saving Medications Act of 2011, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 to repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program; HR 1214 a bill to repeal mandatory funding for school-based health center construction, it amends the Patient Protection and Affordable Care Act to repeal the program requiring the Secretary of Health and Human Services (HHS) to award grants to school-based health centers or their sponsoring facilities to support the operation of such health centers. Rescinds unobligated appropriations for the program. Urging that final Accounting of Disclosures rule not include the proposal to require provision of an access report to patients; HR 1540 National Defense Authorization Act of 2012, a bill to establish a working group within the Department of Defense to comprehensively review all TRICARE policies and practices related to pediatric care and to develop recommendations that specifically address the health care needs of children of military families; S 1854 Medical Surge Capacity Act, a bill to enhance medical surge capacity which uses lessons learned from previous disasters to make critical changes when responding to a natural or manmade disaster; HR 2405 and S 1855 Pandemic and All-Hazards Preparedness Act Reauthorization of 2011, a bill to amend the Public Health Service Act to reauthorize various programs under the Pandemic and All-Hazards Preparedness Act; S. 1979 Conrad State 30 Improvement Act (Immigration) , a bill to help streamline J-1 visa waiver process for hospitals to hire international physicians to practice in rural and medically underserved communities; Critical Access Hospital (CAH) Letter from Rep. Ron Kind and Rep. Jo Ann Emerson to the supercommittee to protect CAH from potential cuts or other detrimental policy changes; Urging the Super Committee to reject cuts to inpatient rehabilitation facilities (IRFs); Extender's letter to supercommittee with a list of hospital specific issues that need to be addressed; HR 3586 Good Samaratin Health Professionals Act, a bill to amend the PHSA to limit the liability of healthcare professionals who volunteer to provide healthcare services in response to disaster; HR 3839 Drug Shortage Prevention Act of 2012, to address critical drug shortage; S 2193 Ensuring Safe Medical Devices for Patients, a bill to require the Food and Drug Administration to include devices in the postmarket risk identification and analysis system, to expedite the implementation of the unique device identification system for medical devices; HR 4246 VA Enrollment Act, to amend title 38, United States Code, to provide for the expansion of eligibility for veteran reimbursement for emergency treatment provided in non-Department of Veterans Affairs facilities; HR 5800 Health Care Price Transparency Promotion Act of 2012, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; H.R.6118 and S.3391 Taking Essential Steps for Testing Act of 2012. to amend the Public Health Service Act to revise sanctions for laboratories that intentionally refer proficiency testing samples required for certification to another laboratory for analysis by: (1) giving the Secretary of Health and Human Services (HHS) discretion to substitute intermediate sanctions for such violations instead of the two-year prohibition against ownership or operation which would otherwise apply, and (2) making the one-year certificate revocation for such a laboratory optional rather than mandatory. Which gives CMS more discretion in enforcing the Clinical Laboratory Improvement Amendments to preserve patient access to lab services.

Client expense: $5,350,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 4310, National Defense Authorization Act (McKeon) TRICARE provisions H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5817, Eliminate Privacy Notice Confusion Act (Luetkemeyer) privacy H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services H.R. 6684, Spending Reduction Act (Ryan) ACA provisions, deficit reduction proposals H.J.Res. 17, Continuing Appropriations Resolution (Rogers) temporary appropriations for FY 2013 S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1223, Location Privacy Protection Act (Franken) privacy S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3254, National Defense Authorization Act (Levin) TRICARE provisions S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy S. 3414, Cybersecurity Act (Lieberman) privacy, data security S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal Regulatory Descriptions (con't): requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; and other issues relating to health care reform implementation.

Client expense: $2,020,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

See page five for specific HCR issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. MMM Medicare/Medicaid Issues H.R. 5 - Protecting Access to Healthcare Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 3474 - PRIME Act of 2011 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 Accountable Care Organizations Final Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Medicare SGR and Overseas Contingency Operations funds Inspiring Quality Campaign IPAB CMS RUC Refinement Ambulatory Surgical Centers Medicare Liability Reform Trauma center designation Trauma GAO study Imaging Pediatric subspecialty loan repayment program Rx Drug shortages Cancer programs appropriations Trauma Appropriations Children's Hospitals Graduate Medical Education Payment Program funding RUC Refinement panel valuation problem HHS ASPR/MSET Program Medical Device User Fee and Modernization Act (MDUFMA) Health Information Technology (45 CFR Part 170) NIH Appropriations Electronic Health Record Meaningful Use Stage 2 Proposed Rule Surgical workforce issues Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Medicare audit programs

Client expense: $88,958 · Firm income: Not reported

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

See page five for specific Health Care Issues. HCR Health Care Issues H.R. 5 - Protecting Access to Healthcare Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 3474 - PRIME Act of 2011 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 Accountable Care Organizations Final Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Medicare SGR and Overseas Contingency Operations funds Inspiring Quality Campaign IPAB CMS RUC Refinement Ambulatory Surgical Centers Medicare Liability Reform Trauma center designation Trauma GAO study Imaging Pediatric subspecialty loan repayment program Rx Drug shortages Cancer programs appropriations Trauma Appropriations Children's Hospitals Graduate Medical Education Payment Program funding RUC Refinement panel valuation problem HHS ASPR/MSET Program Medical Device User Fee and Modernization Act (MDUFMA) Health Information Technology (45 CFR Part 170) NIH Appropriations Electronic Health Record Meaningful Use Stage 2 Proposed Rule Surgical workforce issues Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Medicare audit programs

Client expense: $88,958 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (MMM Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $16,647 · Firm income: Not reported

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

See page six for specific Health Care Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (HCR Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $16,647 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (MMM Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $87,126 · Firm income: Not reported

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

See page six for specific Health Care Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (HCR Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $87,126 · Firm income: Not reported

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

See page 3 for specific lobbying issues H.R. 2 - Repealing the Job-Killing Health Care Law Act H.R. 5/S. 218/S.1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 8 American Taxpayer Relief Act of 2012 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 733 - Recalcitrant Cancer Research Act of 2012 H.R.1172 - Medicare Lung Cancer Early Detection Promotion Act of 2011 H.R. 1256 - Medicare Physician Payment Transparency and Assessment Act of 2011 H.R. 1394/S.752 - Lung Cancer Mortality Reduction Act H.R. 2219 - Department of Defense Appropriations Act - Provisions related to funding for Lung Cancer research only H.R. 3475 - Keeping IDs Safe Act - Provisions related to Pediatric Subspecialty Loan Repayment Program H.R. 3526/S. 438 - Heart Disease Education, Analysis, Research, and Treatment for Women (HEART for Women) Act H.R. 3630/3743/3765 - Temporary Payroll Tax Cut Continuation Act of 2011 - Provisions related to Medicare physician payment only H.R. 4310 - National Defense Authorization Act - Provisions related to recalcitrant cancer only H.Res. 9 - Instructing certain committees to report legislation replacing the job-killing health care law H.J. Res. 48 - Additional Continuing Appropriations Amendments, 2011 S. 362 - Pancreatic Cancer Research and Education Act (companion to HR 733) S. 668 - Health Care Bureaucrats Elimination Act S. 756 Medicare Data Access for Transparency and Accountability Act Section 5203 of the Affordable Care Act (P.L. 111-148) - Provisions on Health Care Workforce Loan Repayment Programs S. 1534 - Identify Theft and Tax Fraud Prevention Act - Provisions on Social Security Death Master File Health care reform, health care quality improvement; physician workforce; comparative effectiveness research; health information technology; HIT Meaningful Use; Sustainable Growth Rate; Independent Payment Advisory Board; accountable care organizations; resident work hours; Patient Centered Outcomes Research Institute; Center for Medicare and Medicaid Innovation; MEDCAC; Joint Select Committee on Deficit Reduction; Social Security Death Master File; Coverage with Evidence Development; ICD-10 Implementation; health care-associated infections; Physician Payment Sunshine Act; Physician Fee Schedule; Inpatient Prospective Payment System; Value Based Update (VBU) Proposal; Sequestration

Client expense: $170,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

See page 5 for specific lobbying issues. H.R. 2 - Repealing the Job-Killing Health Care Law Act H.R. 5/S. 218/S.1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 8 American Taxpayer Relief Act of 2012 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R.1172 - Medicare Lung Cancer Early Detection Promotion Act of 2011 H.R. 1256 - Medicare Physician Payment Transparency and Assessment Act of 2011 H.R. 3475 - Keeping IDs Safe Act - Provisions related to Pediatric Subspecialty Loan Repayment Program H.R. 3630/3743/3765 - Temporary Payroll Tax Cut Continuation Act of 2011 - Provisions related to Medicare physician payment only H.Res. 9 - Instructing certain committees to report legislation replacing the job-killing health care law H.J. Res. 48 - Additional Continuing Appropriations Amendments, 2011 S. 668 - Health Care Bureaucrats Elimination Act S. 756 Medicare Data Access for Transparency and Accountability Act Health care reform, health care quality improvement; physician workforce; comparative effectiveness research; health information technology; HIT Meaningful Use; Sustainable Growth Rate; Independent Payment Advisory Board; accountable care organizations; resident work hours; Patient Centered Outcomes Research Institute; Center for Medicare and Medicaid Innovation; MEDCAC; Coverage with Evidence Development

Client expense: $170,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Monitoring and lobbied issues related to medical malpractice reform; entire bills of the following: H.R.816, the Provider Shield Act of 2011 H.R.5 (H.RES.591, H.RES.596, H.R.3682, H.R.5652, S.12, S.218, S.1099), Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitoring and lobbied issues related to healthcare; entire bills of the following: H.R.816, the Provider Shield Act of 2011 H.R.5 (H.RES.591, H.RES.596, H.R.3682, H.R.5652, S.12, S.218, S.1099), Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5/S. 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act (entire bill) H.R.3139, District of Columbia National Disaster Insurance Protection Act (entire bill) S. 669, Longshore and Harbor Workers' Compensation Act Amendments (entire bill) H.R. 890, Holocaust Insurance Accountability Act (entire bill) S. 466, Restoration of Legal Rights for Claimants Under Holocaust-Era Insurance Policies Act (entire bill) H.R. 1150, Competitive Health Insurance Reform Act (entire bill) H.R. 1063/ S. 1718, Strengthening Medicare and Repaying Tax Payers Act (entire bill) H.R. 2099, Natural Disaster Mitigation Act of 2011 (entire bill) H.R. 2100, Catastrophe Savings Accounts Act of 2011 (entire bill) H.R. 2101, Policyholder Disaster Protection Act of 2011 (entire bill) S. 1091, COASTAL Act of 2011 (entire bill) H.R. 2126, Risk Retention Modernization Act of 2011 (entire bill) S. 1383, Save Child Support Act (Sec 5, Requiring States to Compare Information Maintained by insurers; Sec 6, Data Matching and Registry of Payments made on property and casualty insurance) H.R. 3125, Earthquake Insurance Affordability Act (entire bill) S. 1630, Disaster Recovery Act of 2011 (entire bill) H.R.3534, Security in Bonding Act of 2011 (entire bill) H.R. 5284, Medicare Secondary Payer and Workers Compensation Settlement Agreements Act of 2012 (entire bill) H.R. 3559, Insurance Data Protection Act (entire bill) H.R.1845, Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012 (Title II) H.R. 6346, To amend the Fair Labor Standards Act of 1938 to provide a specific limited exemption from the overtime pay requirements of such Act for work related to insurance claims adjustment after a major disaster. S.3677, A bill to make a technical correction to the Flood Disaster Protection Act of 1973. Terrorism Risk Insurance Program Reauthorization

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

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

H.R. 816, Provider Shield Act (entire bill) H.R. 1873/ S. 987, Arbitration Fairness Act (entire bill) S. 890, Fighting Fraud to Protect Taxpayers Act (entire bill) H.R. 966/ S. 420, Lawsuit Abuse Reduction Act (entire bill) H.R. 592/ S. 623, Sunshine in Litigation Act (entire bill) H.R. 5/ S. 1099, Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act (entire bill) H.R.3586, Good Samaritan Health Professionals Act of 2011 (entire bill) S.1652, Consumer Mobile Fairness Act of 2011 (entire bill) H.R. 4369/ S. 3076, H.R. 4369: Furthering Asbestos Claim Transparency (FACT) Act of 2012 (entire bill)

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

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

H.R. 1406, Fairness to Pet Owners Act of 2011 H.R. 2248, Medicare Prescription Drug Price Negotiation Act of 2011 S. 1099, Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 436, Health Care Cost Reduction Act of 2012 S. 1855, Pandemic All-hazards Preparedness Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), SENATE

the Patients' Freedom to Choose Act (H.R. 605/S. 312) the HEALTH Act of 2011 (H.R. 5/S. 1099) the Protect Medical Innovation Act of 2011 (H.R. 436) the Preserving Access to Life-Saving Medications Act (S. 296/H.R. 2245)

Client expense: $30,430 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Office of Natl Drug Control Policy (NDCP), SENATE

National HIV/AIDS Strategy (general); Emergency Contraception (general); H.R. 2679/S. 1440, PREEMIE. H.R. 2954, Health Equity Accountability Act; HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Health IT (general); H.R. 2029/ S.1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); H.R. 2127, Newborn Act; H.R. 5/ S.1099, HEALTH Act; H.R. 452, Medicare Decisions Accountability Act of 2011; S.668, Health Care Bureaucrats Elimination Act; H.R.666, Birth Certificate Enhancement Act of 2011; H.R. 894, Maternal Health Accountability Act; Imaging (general); H.R. 2194/ S.1221, GEDI Act; H.R. 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); H.R. 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; H.R. 2085/ S. 1214; Essential Health Benefits (general); Graduate Medical Education (general); H.R. 3418/ S. 1862, Stillbirth & SUID Prevention, Education & Awareness Act; Quality Improvement Measurement (general); H.R. 3620/ S. 1969, Quality Care for Moms and Babies Act; H.R. 3522 Family Act; Contraception (general); Preeclampsia (general); Antibiotics (general); NICHD Reorganization (general); CMS Provider Penalties (general); National Health Services Corps (general); Abortion (general); H.R. 2299, Child Interstate Abortion Notification Act; S. 2262, Advancing FASD Research, Prevention, and Services Act; CMS Health IT incentive program, meaningful use Stage 2; H.R. 2104/S. 3338, Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011; H.R. 5647/S. 3565, Pregnant Workers Fairness Act; H.R. 4628, Interest Rate Reduction Act; Immigrant Health Care Access; H.R. 6598, Electronic Health Records Improvement Act.

Client expense: $245,727 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Health reform and its effect on the self-employed. Pooling mechanisms for access to health coverage . Implementation and improvement of the Patient Protection and Affordable Care Act. Expanding and preserving Health Savings Accounts and Health Reimbursement Arrangements. Legislation:Repealing the Job-Killing Health Care Law Act(H.R.2:S.192). Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH)Act(H.R.5;S.218 & S.1099). Medicare Decisions Accountability Act (H.R. 452). Support for the American Job Protection Act(S. 20) and the American Job Protection Act(H.R. 1744). Support for the Health Equity Act of 2011(H.R. 2662).Support the full deduction of health insurance costs provided by America's Small Business Tax Relief Act of 2012(H.R. 6102). Support Small Business Jobs and Tax Relief Act(S. 2237) . Support for Restoring Tax and Regulatory Certainty to Small Businesses Act of 2012 (S.3572).

Client expense: $182,045 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA), Treasury, Dept of

Medical Liability Reform; in general. HR 5/S 218/S 1099 - Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act of 2011; all provisions. HR 5 - The Protecting Access to Healthcare (PATH) Act; all provisions.

Client expense: $160,000 · 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), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA)

Issues relating to oral-health and dental practice in the following bills: H.R. 2/S. 192, Repealing the Job-Killing Health Care Law Act; H.R. 5/S. 218, S. 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; H.R. 38, A bill to rescind funds appropriated to the Health Insurance Reform Implementation Fund under the Health Care and Education Reconciliation Act of 2010; HR105, Empowering Patients First Act; HR157, Health Care Safety Net Enhancement Act of 2011; HR165, Informed Choice Act; H.R. 969, the Medical Practice Freedom Act of 2011; H.R. 314, Medical Liability Procedural Reform Act of 2011; H.R. 570, Dental Emergency Responder Act; H.R. 1578/S. 1765, Violence Against Women Health Initiative Act of 2011; H.R. 2119, Ryan Creedon Act of 2011; H.R. 2405/S. 1855, Pandemic and All Hazards Preparedness Act of 2011; H.R. 3586, Good Samaritan Health Professionals Act of 2011; S. 197, Medical Care Access Protection (MCAP) Act of 2011; S. 312/H.R. 605, Patients Freedom to Choose Act; S. 966, Bone Health Promotion and Research Act of 2011; S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act; S. 1878/H.R. 4091, Coordination of Pro Bono Medically Recommended Dental Care Act; S. 1925, Violence Against Women Reauthorization Act of 2011; H.R. 3765, Temporary Payroll Tax Cut Continuation Act of 2011; H.R. 3839, Drug Shortage Prevention Act of 2012; S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act; S. 3187 [H.R. 5651] - Prescription Drug User Fee Act. H.R. 5909 - Comprehensive Dental Reform Act of 2012 H.R. 5979 - Medicaid Accountability and Care Act of 2012 S. 3272 - Comprehensive Dental Reform Act of 2012 Community water fluoridation Medicaid and CHIP Payment and Access Commission: -Center for Consumer Information and Insurance Oversight; -Center for Medicaid, CHIP and Survey and Certification; Implementation of P.L. 111-148; 111-152, Patient Protection and Affordable Care Act; Oral-health issues within Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020, Healthy People 2020; Comments on planning and establishment of state level exchanges; Office of the Assistant Secretary for Preparedness and Response, National Health Security Strategy (biennial implementation plan), National Disaster Medical System (disaster medical assistance team) regarding issues related to utlization of dental professionals in the event of a disaster; Office of Global Health (United Nations high-level meeting on non-communicable diseases); Division of Oral Health Reorganization; CMS Limited English Proficiency Guidelines; Advisory Committee on Training in Primary Care Medicine and Dentistry Nominations, Ninth Report to Congress; National Advisory Dental and Craniofacial Research Council Nominations; Center for Substance Abuse Treatment, National Recovery Month; United Nations Summit on Non-Communicable Diseases; National Drug Control Strategy / Prescription Drug Abuse Prevention Plan; DEA National Prescription Drug Take Back Campaign; FDA Center for Drug Evaluation and Research regarding dry mouth labeling; Medical/Dental Coding Issues; Comparative Effectiveness regarding Dental Quality Alliance; Health Information Technology (HIT) Regulations; Health care issues before the Joint Select Committee on Deficit Reduction. United Nations General Assembly's High-level Meeting on Non-communicable Diseases CMS proposed rule on reporting and returning Medicare overpayments Food and Drug Administration Sedation Product Guidance Centers for Disease Control and Prevention recommendations for identification of persons with Hepatitis C (HCV) chronic infection H.R. 5711 - Access to Substance Abuse Treatment Act of 2012 Department of Health and Human Services media campaign to educate the public about the dangers of tobacco use SAMHSA National Recovery Month Food and Drug Administration clinical development and use of sedation products Surgeon General report on sugar-sweetened beverages S. 3562, Older Americans Act Amendments of 2012 HR 436, Protect Medical Innovation Act of 2011 (Medical Device Tax) HR 488, Save Our Medical Devices Act of 2011 (Medical Device Tax) S 17, Medical Device Access and Innovation Protection Act (Medical Device Tax) S 262, To repeal the excise tax on medical device manufacturers (Medical Device Tax)

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

Government targets: Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 8- American Taxpayer Relief Act of 2012 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.376-Volunteer Emergency Services Recruitment and Retention Act of 2011 H.R.436-Health Care Cost Reduction Act of 2012 H.R.452-Medicare Decisions Accountability Act of 2011 H.R.541-Pay for all your Undocumented Procedures (PAY UP) Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.969- Medical Practice Freedom Act of 2011 H.R. 971-Critical Care Assessment and Improvement Act of 2011 H.R.1004-Health Flexible Spending Arrangements Improvements Act of 2012 H.R.1117-Air Ambulance Patient Safety, Protection, and Coordination Act H.R. 1063-Strengthening Medicare And Repaying Taxpayers Act of 2011 H.R. 1206- Access to Professional Health Insurance Advisors Act of 2011 H.R.1256-Medicare Physician Payment Transparency and Assessment Act of 2011 H.R.1310-To amend the Internal Revenue Code of 1986 to exempt certain emergency medical devices from the excise tax on medical devices, and for other purposes H.R.1629-Family Health Care Accessibility Act of 2011 H.R.1668-Danny McIntosh Emergency Medical Service Providers Protection Act H.R.1683-State Flexibility Act H.R.1852-Children's Hospital GME Support Reauthorization Act of 2011 H.R.1941-Hiring Heroes Act of 2011 H.R.2104-Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2353-Volunteer Responder Incentive Protection Reauthorization Act of 2011 H.R.2405-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.2488-SERVE Act of 2011 H.R.2523-Physician Availability Act of 2011 H.R.2853-Emergency Medic Transition (EMT) Act of 2011 H.R.2903-Federal Emergency Management Agency (FEMA) Reauthorization Act of 2012 H.R.3000-Empowering Patients First Act H.R.3144-Field EMS Quality Innovation and Cost Effectiveness Improvements Act H.R.3269-Diagnostic Imaging Services Protection Act of 2011 H.R.3511- Cardiac Arrest Survival Act of 2011 H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R.3625-Cardiomyopathy Health Education, Awareness, Risk Assessment, and Training in the Schools (HEARTS) Act of 2011 H.R.4124-Veteran Emergency Medical Technician Support Act of 2012 H.R.4242-Ensuring Quality Health Care for All Americans Act of 2012 H.R.5707-Medicare Physician Payment Innovation Act of 2012 H.R.5842-Restoring Access to Medication Act of 2012 H.R.5858-Health Savings Accounts Improvements Act of 2012 H.R. 6079-Repeal of Obama Care Act H.R. 6142-Assuring Medicare Stability and Access for Seniors Act of 2012 H.R. 6163-National Pediatric Research Network Act of 2012 H.R. 6562-Resident Physician Shortage Reduction Act of 2012 H.R. 6672- Pandemic and All-Hazards Preparedness Reauthorization Act of 2012 H.R. 6719- Telehealth Promotion Act of 2012 S.223-FAA Air Transportation Modernization and Safety Improvement Act S.385-Dale Long Emergency Medical Services Providers Protection Act S.668-Health Care Bureaucrats Elimination Act S.868-State Flexibility Act S.932-SERVE Act of 2011 S.933-Volunteer Responder Incentive Protection Reauthorization Act of 2011 S.951-Hiring Heroes Act of 2011 S.958-Children's Hospital GME Support Reauthorization Act of 2011 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 S.1407-Air Ambulance Medicare Accreditation and Accountability Act S.1855-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011

Client expense: $695,377 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.1629-Family Health Care Accessibility Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R. 6163-National Pediatric Research Network Act of 2012 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011

Client expense: $695,377 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support: S. 533, Lawsuit Abuse Reduction Act of 2011, and House companion bill, HR 966; S. 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, and House companion bill HR 5; HR 816, Provider Shield Act of 2011; and HR 4369, the Furthering Asbestos Claim Transparency (FACT) Act of 2012. Oppose: S. 623, Sunshine in Litigation Act of 2011; and S. 3220, Paycheck Fairness Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support: S. 533, Lawsuit Abuse Reduction Act of 2011, and House companion bill, HR 966; S. 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, and House companion bill HR 5; HR 816, Provider Shield Act of 2011; and HR 4369, the Furthering Asbestos Claim Transparency (FACT) Act of 2012. Oppose: S. 623, Sunshine in Litigation Act of 2011; and S. 3220, Paycheck Fairness Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 and HR 2245 Preserving Access to Life-Saving Medications Act of 2011, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 to repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program; HR 1214 a bill to repeal mandatory funding for school-based health center construction, it amends the Patient Protection and Affordable Care Act to repeal the program requiring the Secretary of Health and Human Services (HHS) to award grants to school-based health centers or their sponsoring facilities to support the operation of such health centers. Rescinds unobligated appropriations for the program. Urging that final Accounting of Disclosures rule not include the proposal to require provision of an access report to patients; HR 1540 National Defense Authorization Act of 2012, a bill to establish a working group within the Department of Defense to comprehensively review all TRICARE policies and practices related to pediatric care and to develop recommendations that specifically address the health care needs of children of military families; S 1854 Medical Surge Capacity Act, a bill to enhance medical surge capacity which uses lessons learned from previous disasters to make critical changes when responding to a natural or manmade disaster; HR 2405 and S 1855 Pandemic and All-Hazards Preparedness Act Reauthorization of 2011, a bill to amend the Public Health Service Act to reauthorize various programs under the Pandemic and All-Hazards Preparedness Act; S. 1979 Conrad State 30 Improvement Act (Immigration) , a bill to help streamline J-1 visa waiver process for hospitals to hire international physicians to practice in rural and medically underserved communities; Critical Access Hospital (CAH) Letter from Rep. Ron Kind and Rep. Jo Ann Emerson to the supercommittee to protect CAH from potential cuts or other detrimental policy changes; Urging the Super Committee to reject cuts to inpatient rehabilitation facilities (IRFs); Extender's letter to supercommittee with a list of hospital specific issues that need to be addressed; HR 3586 Good Samaratin Health Professionals Act, a bill to amend the PHSA to limit the liability of healthcare professionals who volunteer to provide healthcare services in response to disaster; HR 3839 Drug Shortage Prevention Act of 2012, to address critical drug shortage; S 2193 Ensuring Safe Medical Devices for Patients, a bill to require the Food and Drug Administration to include devices in the postmarket risk identification and analysis system, to expedite the implementation of the unique device identification system for medical devices; HR 4246 VA Enrollment Act, to amend title 38, United States Code, to provide for the expansion of eligibility for veteran reimbursement for emergency treatment provided in non-Department of Veterans Affairs facilities; HR 5800 Health Care Price Transparency Promotion Act of 2012, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; H.R.6118 and S.3391 Taking Essential Steps for Testing Act of 2012. to amend the Public Health Service Act to revise sanctions for laboratories that intentionally refer proficiency testing samples required for certification to another laboratory for analysis by: (1) giving the Secretary of Health and Human Services (HHS) discretion to substitute intermediate sanctions for such violations instead of the two-year prohibition against ownership or operation which would otherwise apply, and (2) making the one-year certificate revocation for such a laboratory optional rather than mandatory. Which gives CMS more discretion in enforcing the Clinical Laboratory Improvement Amendments to preserve patient access to lab services.

Client expense: $3,550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 2 Repealing the Job-Killing Health Care Law Act; H.R. 4 Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act; H.R. 1063 Strengthening Medicare and Repaying Taxpayers Act; S. 18 Small Business Paperwork Mandate Elimination Act; S. 19 American Liberty Restoration Act; S. 20/H.R. 1744 American Job Protection Act; Affordable Care Act, all provisions; S. 192 Repealing the Job-Killing Health Care Law Act; S. 312 Patients Freedom to Choose Act; Health Care Reform; Health Care Mandate Penalties; Employer/Employee Flexibility; Consumer-Directed Health Care; Health Insurance Exchanges; Medicare Secondary Payer Judgments; Comments on FDA's Suggested Questions & Answers for the Final Patient Protection & Affordable Care Act Section 4205 Guidance; Comments on IRS' "Shared Responsibility for Employers Regargding Health Care Coverage (IRC Sec. 1513)"; H.R.1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, all provisions; H.R.2077, MLR Repeal Act of 2011, all provisions; S.1098, Family and Retirement Health Investment Act of 2011, all provisions; H.R.5/S.1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, all provisions; H.R.1206, Access to Professional Health Insurance Advisors Act of 2011, all provisions; Summary of Benefit NRPM; Comments regarding employer interactions with insurance exchanges, health premium tax credits, and development of an affordability safe harbor for employers; S.1880, Jobs and Premium Protection Act, all provisions; S.1049/H.R. 2676, Small Business Health Relief Act of 2011, all provisions; H.R.2206, Auto Enroll Repeal Act, all provisions.; H.R. 6079, Repeal of Obamacare Act, all provisions.

Client expense: $820,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Motor Carrier Safety Administration, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office

See page 3 for specific lobbying issues H.R. 2 - Repealing the Job-Killing Health Care Law Act H.R. 5/S. 218/S.1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 733 - Recalcitrant Cancer Research Act of 2012 H.R.1172 - Medicare Lung Cancer Early Detection Promotion Act of 2011 H.R. 1256 - Medicare Physician Payment Transparency and Assessment Act of 2011 H.R. 1394/S.752 - Lung Cancer Mortality Reduction Act H.R. 2219 - Department of Defense Appropriations Act - Provisions related to funding for Lung Cancer research only H.R. 3475 - Keeping IDs Safe Act - Provisions related to Pediatric Subspecialty Loan Repayment Program H.R. 3526/S. 438 - Heart Disease Education, Analysis, Research, and Treatment for Women (HEART for Women) Act H.R. 3630/3743/3765 - Temporary Payroll Tax Cut Continuation Act of 2011 - Provisions related to Medicare physician payment only H.Res. 9 - Instructing certain committees to report legislation replacing the job-killing health care law H.J. Res. 48 - Additional Continuing Appropriations Amendments, 2011 S. 362 - Pancreatic Cancer Research and Education Act (companion to HR 733) S. 668 - Health Care Bureaucrats Elimination Act S. 756 Medicare Data Access for Transparency and Accountability Act Section 5203 of the Affordable Care Act (P.L. 111-148) - Provisions on Health Care Workforce Loan Repayment Programs S. 1534 - Identify Theft and Tax Fraud Prevention Act - Provisions on Social Security Death Master File Health care reform, health care quality improvement; physician workforce; comparative effectiveness research; health information technology; HIT Meaningful Use; Sustainable Growth Rate; Independent Payment Advisory Board; accountable care organizations; resident work hours; Patient Centered Outcomes Research Institute; Center for Medicare and Medicaid Innovation; MEDCAC; Joint Select Committee on Deficit Reduction; Social Security Death Master File; Coverage with Evidence Development; ICD-10 Implementation; health care-associated infections; Physician Payment Sunshine Act; Physician Fee Schedule; Inpatient Prospective Payment System; Value Based Update (VBU) Proposal; Sequestration

Client expense: $125,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

See page 5 for specific lobbying issues. H.R. 2 - Repealing the Job-Killing Health Care Law Act H.R. 5/S. 218/S.1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R.1172 - Medicare Lung Cancer Early Detection Promotion Act of 2011 H.R. 1256 - Medicare Physician Payment Transparency and Assessment Act of 2011 H.R. 3475 - Keeping IDs Safe Act - Provisions related to Pediatric Subspecialty Loan Repayment Program H.R. 3630/3743/3765 - Temporary Payroll Tax Cut Continuation Act of 2011 - Provisions related to Medicare physician payment only H.Res. 9 - Instructing certain committees to report legislation replacing the job-killing health care law H.J. Res. 48 - Additional Continuing Appropriations Amendments, 2011 S. 668 - Health Care Bureaucrats Elimination Act S. 756 Medicare Data Access for Transparency and Accountability Act Health care reform, health care quality improvement; physician workforce; comparative effectiveness research; health information technology; HIT Meaningful Use; Sustainable Growth Rate; Independent Payment Advisory Board; accountable care organizations; resident work hours; Patient Centered Outcomes Research Institute; Center for Medicare and Medicaid Innovation; MEDCAC; Coverage with Evidence Development

Client expense: $125,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 816, Provider Shield Act (entire bill) H.R. 1873/ S. 987, Arbitration Fairness Act (entire bill) S. 890, Fighting Fraud to Protect Taxpayers Act (entire bill) H.R. 966/ S. 420, Lawsuit Abuse Reduction Act (entire bill) H.R. 592/ S. 623, Sunshine in Litigation Act (entire bill) H.R. 5/ S. 1099, Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act (entire bill) H.R.3586, Good Samaritan Health Professionals Act of 2011 (entire bill) S.1652, Consumer Mobile Fairness Act of 2011 (entire bill) H.R. 4369/ S. 3076, H.R. 4369: Furthering Asbestos Claim Transparency (FACT) Act of 2012 (entire bill)

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

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

H.R. 5/S. 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act (entire bill) HR 1309, Flood Insurance Reform Act of 2011(entire bill) S.1864, A bill to extend the National Flood Insurance Program until September 30, 2012 (entire bill) H.R.3139, District of Columbia National Disaster Insurance Protection Act (entire bill) S. 669, Longshore and Harbor Workers' Compensation Act Amendments (entire bill) H.R. 890, Holocaust Insurance Accountability Act (entire bill) S. 466, Restoration of Legal Rights for Claimants Under Holocaust-Era Insurance Policies Act (entire bill) H.R. 1150, Competitive Health Insurance Reform Act (entire bill) H.R. 1063/ S. 1718, Strengthening Medicare and Repaying Tax Payers Act (entire bill) H.R. 2099, Natural Disaster Mitigation Act of 2011 (entire bill) H.R. 2100, Catastrophe Savings Accounts Act of 2011 (entire bill) H.R. 2101, Policyholder Disaster Protection Act of 2011 (entire bill) S. 1091, COASTAL Act of 2011 (entire bill) H.R. 2126, Risk Retention Modernization Act of 2011 (entire bill) S. 1383, Save Child Support Act (Sec 5, Requiring States to Compare Information Maintained by insurers; Sec 6, Data Matching and Registry of Payments made on property and casualty insurance) H.R. 3125, Earthquake Insurance Affordability Act (entire bill) S. 1630, Disaster Recovery Act of 2011 (entire bill) H.R.3534, Security in Bonding Act of 2011 (entire bill) S.1940, Flood Insurance Reform and Modernization Act of 2011 (entire bill) H.R. 5284, Medicare Secondary Payer and Workers Compensation Settlement Agreements Act of 2012 (entire bill) H.R. 5740, National Flood Insurance Program Extension Act (entire bill) H.R. 4348, MAP-21 (Division F; Title II) H.R. 3559, Insurance Data Protection Act (entire bill) Terrorism Risk Insurance Program Reauthorization

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

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

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R.611 -- BEST PRACTICES Act (Rush) - data security. H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information. H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians. H.R. 1707, Data Accountability and Trust Act (Rush) - data security. H.R. 1841, Data Accountability and Trust Act (Stearns) - data security. H.R. 2576, (Black) - eligibility for health care assistance. H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security. H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions. H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency. H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services. Labor, HHS, Education Appropriations Act (Rehburg) - funding for HHS programs and agencies. H.J.Res. 17, Continuing Appropriations Resolution (Rogers) - temporary appropriations for FY 2013. S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions. S. 1099, HEALTH Act (Blunt) - medical liability reform. S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security. S. 1207, Data Security and Breach Notification Act (Pryor) - data security. S. 1408, Data Breach Notification Act (Feinstein) - data security. S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security. S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees. S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy. S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services. S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments. S. 3333, Data Security and Breach Notification Act (Toomey) - data security. S. 3351, Protect Our Health Privacy Act (Franken) - privacy. S. 3414, Cybersecurity Act (Lieberman) - privacy, data security. S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) - privacy.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and issues relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); Nurse Education, Expansion, and Development Act; Nursing provisions in potential job creation legislation; Anti-competitive barriers to practice; Negotiated Rulemaking on Designation of Medically Underserved and Health Professional Shortage Areas; Administration review of current regulations; Prevention and Public Health Fund; Definition of essential health benefits; Health information technology and electronic health records; HRSA nurse practitioner national sample survey; Amendments to the Consumer Product Safety Improvement Act; Menu and Nutrition Labeling; Draft legislation to reauthorize the Prescription Drug User Fee Act (PDUFA); Draft legislation on Congressional Budget Office scoring of preventive health services; Draft legislation on voluntary tandem licensing and credentialing for federal telemedicine services; Draft legislation on reauthorization of the National Quality Forum; H.R. 5/S. 218/S. 1099 - Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act; H.R. 5 - Protecting Access to Healthcare (PATH) Act; H.R. 451 - Healthcare Truth and Transparency Act of 2011; S. 248/H.R. 844 - Empowering States to Innovate Act; S. 174 - Healthy Lifestyles and Prevention Act; H.R. 10/S. 299/S. 1720/S. 1786 - Regulations From the Executive in Need of Scrutiny (REINS) Act; H.R. 1217 - to repeal the Prevention and Public Health Fund; H.R. 1683/S. 868 - State Flexibility Act; H.R. 2465 - Federal Workers' Compensation Modernization and Improvement Act; S. 261 - Federal Employees' Compensation Reform Act; H.R. 469 - Protecting Student Athletes from Concussions Act; S. 601/H.R. 1127 - Childrens Sports Athletic Equipment Safety Act; Concussion Treatment and Care Tools (ConTACT) Act; S. 54 - Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act; S. 55 - Nursing School Clinics Act; H.R. 157 - Health Care Safety Net Enhancement Act; H.R. 227 - Child Gun Safety and Gun Access Prevention Act; H.R. 338 - Protecting Our Kids' Medicine Act; H.R. 469 - Protecting Student Athletes from Concussions Act; H.R. 576 - Healthy Children Through School Nutrition Education Act; H.R. 713 - Keeping Families Together Act; H.R. 751 - Mental Health in Schools Act; H.R. 1214 - to repeal mandatory funding for school-based health center construction; S. 961 - Reconnecting Youth to Prevent Homelessness Act; S. 1165, Button Cell Battery Safety Act; H.R. 1852/S. 958 - Childrens Hospital GME Support Reauthorization Act; H.R. 115 - CHAMPVA Childrens Protection Act; H.R. 364 - Common Sense Health Reform Americans Actually Want Act; H.R. 614 - Post 9/11 G.I. Bill Dependent Coverage Improvement Act; H.R. 978 - Seniors Identity Protection Act; H.R. 989 - Voluntary State Discount Prescription Drug Plan Act; H.R. 1035/S. 1504 - Medicaid Coverage for Citizens of Freely Associated States Act; H.R. 2029/S. 1131 - Birth Defects Prevention, Risk Reduction, and Awareness Act; H.R. 2758/S. 1463 - Breastfeeding Promotion Act; H.R. 2229 - Student-to-School Nurse Ratio Improvement Act. H.R. 3679 - National Nurse Act; H.R. 4274 - BPCA and PREA Reauthorization Act; S. 2289 - Better Pharmaceuticals and Devices for Children Act; H.R. 5651 - Food and Drug Administration Reform Act; H.R. 5842 - Restoring Access to Medication Act; S. 3187 - FDA Safety and Innovation Act; S. 2474 - Health Equity and Accountability Act; S. 1789 - 21st Century Postal Service Act; S. 847 - Safe Chemicals Act; H.R. 2405/S. 1855 - Pandemic and All-Hazards Preparedness Act (PAHPA); H.R. 2359 - Safe Cosmetics Act; H.R. 6482 - Preventive Health Savings Act; Supplemental Nutrition Assistance Program (SNAP) provisions of H.R. 6083, Federal Agriculture Reform and Risk Management (FARRM) Act, and S.3240, Agriculture Reform, Food, and Jobs Act.

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Legislation and issues relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); Nurse Education, Expansion, and Development Act; Nursing provisions in potential job creation legislation; Anti-competitive barriers to practice; Negotiated Rulemaking on Designation of Medically Underserved and Health Professional Shortage Areas; Administration review of current regulations; Prevention and Public Health Fund; Definition of essential health benefits; Health information technology and electronic health records; HRSA nurse practitioner national sample survey; Draft legislation to reauthorize the Prescription Drug User Fee Act (PDUFA); Draft legislation on Congressional Budget Office scoring of preventive health services; Draft legislation on voluntary tandem licensing and credentialing for federal telemedicine services; Draft legislation on reauthorization of the National Quality Forum; H.R. 5/S. 218/S. 1099 - Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act; H.R. 5 - Protecting Access to Healthcare (PATH) Act; H.R. 451 - Healthcare Truth and Transparency Act of 2011; S. 248/H.R. 844 - Empowering States to Innovate Act; S. 174 - Healthy Lifestyles and Prevention Act; H.R. 10/S. 299/S. 1720/S. 1786 - Regulations From the Executive in Need of Scrutiny (REINS) Act; H.R. 1217 - to repeal the Prevention and Public Health Fund; H.R. 1683/S. 868 - State Flexibility Act; H.R. 2465 - Federal Workers' Compensation Modernization and Improvement Act; S. 261 - Federal Employees' Compensation Reform Act; H.R. 469 - Protecting Student Athletes from Concussions Act; S. 601/H.R. 1127 - Childrens Sports Athletic Equipment Safety Act; Concussion Treatment and Care Tools (ConTACT) Act; H.R. 3679 - National Nurse Act; H.R. 4274 - BPCA and PREA Reauthorization Act; S. 2289 - Better Pharmaceuticals and Devices for Children Act; H.R. 5651 - Food and Drug Administration Reform Act; H.R. 5842 - Restoring Access to Medication Act; S. 3187 - FDA Safety and Innovation Act S. 2474 - Health Equity and Accountability Act; S. 1789 - 21st Century Postal Service Act; H.R. 6482 - Preventive Health Savings Act; Supplemental Nutrition Assistance Program (SNAP) provisions of H.R. 6083, Federal Agriculture Reform and Risk Management (FARRM) Act, and S.3240, Agriculture Reform, Food, and Jobs Act.

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 1406, Fairness to Pet Owners Act of 2011 H.R. 2248, Medicare Prescription Drug Price Negotiation Act of 2011 S. 1099, Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 436, Health Care Cost Reduction Act of 2012

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), SENATE

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson; 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services Labor, HHS, Education Appropriations Act (Rehburg) funding for HHS programs and agencies H.J.Res. 17, Continuing Appropriations Resolution (Rogers) temporary appropriations for FY 2013 S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy S. 3414, Cybersecurity Act (Lieberman) privacy, data security S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; summary of benefits and coverage disclosures; and other issues relating to health care reform implementation.

Client expense: $2,630,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

National HIV/AIDS Strategy (general); Emergency Contraception (general); H.R. 2679/S. 1440, PREEMIE. H.R. 2954, Health Equity Accountability Act; HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Health IT (general); H.R. 2029/ S.1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); The Meaningful End to Defensive Medicine and Aimless Lawsuits; H.R. 2127, Newborn Act; H.R. 5/ S.1099, HEALTH Act; H.R. 452, Medicare Decisions Accountability Act of 2011; S.668, Health Care Bureaucrats Elimination Act; H.R.666, Birth Certificate Enhancement Act of 2011; H.R. 894, Maternal Health Accountability Act; Imaging (general); H.R. 2194/ S.1221, GEDI Act; H.R. 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); H.R. 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; H.R. 2085/ S. 1214; Essential Health Benefits (general); Graduate Medical Education (general); H.R. 3418/ S. 1862, Stillbirth & SUID Prevention, Education & Awareness Act; Quality Improvement Measurement (general); H.R. 3620/ S. 1969, Quality Care for Moms and Babies Act; H.R. 3522 Family Act; Contraception (general); Preeclampsia (general); Antibiotics (general); H.R. 3586, Good Samaritan Health Professionals Act, NICHD Reorganization (general); CMS Provider Penalties (general); National Health Services Corps (general); Abortion (general); H.R. 3803, District of Columbia Pain-Capable Unborn Child Protection Act; H.R. 3541, Prenatal Nondiscrimination Act of 2012; H.R. 2299, Child Interstate Abortion Notification Act; S. 2262, Advancing FASD Research, Prevention, and Services Act; CMS Health IT incentive program, meaningful use Stage 2; H.R. 2104/S. 3338, Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011; H.R. 5647, Pregnant Workers Fairness Act; H.R. 4628, Interest Rate Reduction Act.

Client expense: $312,442 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Health reform and its effect on the self-employed. Pooling mechanisms for access to health coverage . Implementation and improvement of the Patient Protection and Affordable Care Act. Expanding and preserving Health Savings Accounts and Health Reimbursement Arrangements. Legislation:Repealing the Job-Killing Health Care Law Act(H.R.2:S.192). Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH)Act(H.R.5;S.218 & S.1099). Medicare Decisions Accountability Act (H.R. 452). Support for the American Job Protection Act(S. 20) and the American Job Protection Act(H.R. 1744). Support for the Health Equity Act of 2011(H.R. 2662).Support the full deduction of health insurance costs provided by America's Small Business Tax Relief Act of 2012(H.R. 6102). Support Small Business Jobs and Tax Relief Act(S. 2237) . Support for Restoring Tax and Regulatory Certainty to Small Businesses Act of 2012 (S.3572).

Client expense: $170,121 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA), Treasury, Dept of

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.376-Volunteer Emergency Services Recruitment and Retention Act of 2011 H.R.436-Health Care Cost Reduction Act of 2012 H.R.452-Medicare Decisions Accountability Act of 2011 H.R.541-Pay for all your Undocumented Procedures (PAY UP) Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.969- Medical Practice Freedom Act of 2011 H.R. 971-Critical Care Assessment and Improvement Act of 2011 H.R.1004-Health Flexible Spending Arrangements Improvements Act of 2012 H.R.1117-Air Ambulance Patient Safety, Protection, and Coordination Act H.R. 1063-Strengthening Medicare And Repaying Taxpayers Act of 2011 H.R. 1206- Access to Professional Health Insurance Advisors Act of 2011 H.R.1256-Medicare Physician Payment Transparency and Assessment Act of 2011 H.R.1310-To amend the Internal Revenue Code of 1986 to exempt certain emergency medical devices from the excise tax on medical devices, and for other purposes H.R.1629-Family Health Care Accessibility Act of 2011 H.R.1668-Danny McIntosh Emergency Medical Service Providers Protection Act H.R.1683-State Flexibility Act H.R.1852-Children's Hospital GME Support Reauthorization Act of 2011 H.R.1941-Hiring Heroes Act of 2011 H.R.2104-Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2353-Volunteer Responder Incentive Protection Reauthorization Act of 2011 H.R.2405-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.2488-SERVE Act of 2011 H.R.2523-Physician Availability Act of 2011 H.R.2853-Emergency Medic Transition (EMT) Act of 2011 H.R.2903-Federal Emergency Management Agency (FEMA) Reauthorization Act of 2012 H.R.3000-Empowering Patients First Act H.R.3144-Field EMS Quality Innovation and Cost Effectiveness Improvements Act H.R.3269-Diagnostic Imaging Services Protection Act of 2011 H.R.3511- Cardiac Arrest Survival Act of 2011 H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R.3625-Cardiomyopathy Health Education, Awareness, Risk Assessment, and Training in the Schools (HEARTS) Act of 2011 H.R.4124-Veteran Emergency Medical Technician Support Act of 2012 H.R.4242-Ensuring Quality Health Care for All Americans Act of 2012 H.R.5707-Medicare Physician Payment Innovation Act of 2012 H.R.5842-Restoring Access to Medication Act of 2012 H.R.5858-Health Savings Accounts Improvements Act of 2012 H.R. 6079-Repeal of Obama Care Act H.R. 6142-Assuring Medicare Stability and Access for Seniors Act of 2012 H.R. 6163-National Pediatric Research Network Act of 2012 S.223-FAA Air Transportation Modernization and Safety Improvement Act S.385-Dale Long Emergency Medical Services Providers Protection Act S.668-Health Care Bureaucrats Elimination Act S.868-State Flexibility Act S.932-SERVE Act of 2011 S.933-Volunteer Responder Incentive Protection Reauthorization Act of 2011 S.951-Hiring Heroes Act of 2011 S.958-Children's Hospital GME Support Reauthorization Act of 2011 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 S.1407-Air Ambulance Medicare Accreditation and Accountability Act S.1855-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011

Client expense: $433,244 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.1629-Family Health Care Accessibility Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.3000-Empowering Patients First Act H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R.4242-Ensuring Quality Health Care for All Americans Act of 2012 H.R. 6163-National Pediatric Research Network Act of 2012 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011

Client expense: $433,244 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $15,870 · Firm income: Not reported

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