Medicare Audit Improvement Act of 2013

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare ACt of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increasd Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013. S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS) HR 4994, IMPACT Act of 2014 HR 5098 - to amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. HR 4232 - A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. HR 5373 - To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

Client expense: Not reported · Firm income: $120,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare ACt of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increasd Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013. S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS) HR 4994, IMPACT Act of 2014 HR 5098 - to amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. HR 4232 - A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. HR 5373 - To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

Client expense: Not reported · Firm income: $120,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare ACt of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increasd Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013. S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS) HR 4994, IMPACT Act of 2014 HR 5098 - to amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. HR 4232 - A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. HR 5373 - To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

Client expense: Not reported · Firm income: $120,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2053, Medicare Access and CHIP Reauthorization Act of 2015, Issues pertaining to addressing the SGR formula, offsets for legislation and other provisions H.R. 2124, S 1148, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1250, S. 1012, Medicare Audit Improvement Act of 2013, Issues pertaining to RAC audits for hospitals. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.688, H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, Issues pertaining to adjustment for socioeconomic status in the hospital readmissions program. Issues pertaining to the 340B drug pricing program. Issues relating to health IT.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare ACt of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increasd Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013. S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS) HR 4994, IMPACT Act of 2014 HR 5098 - to amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. HR 4232 - A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. HR 5373 - To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

Client expense: Not reported · Firm income: $120,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Patient Protection and Affordable Care Act (Pub. Law 111-148) and the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare/ Medicaid payments as related to the deficit reduction and debt ceiling proposals. Efforts to reform the Medicare physician sustainable growth rate. Medicare sequestration. HR. 4302- The Protecting Access to Medicare Act of 2014 Two Midnight Rule. Recovery Audit Contractor program reform. Third party payment of exchange premiums. HR. 546- "The ACE Kids Act" of 2015 HR. 2329- The Administrative Relief and Accurate Medicare Payments Act of 2013 HR. 1250, S. 1012- Medicare Audit Improvement Act of 2013 Florida's Medicaid Low Income Pool. Georgia's Medicaid DSH Program Tennessee's Medicaid DSH Program

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Health Insurance and Delivery System Reform- Implementation of the Patient Protection and Affordable Care Act (Pub Law 111-148) and the Health Care and Education Reconciliation Act of 2010 (Pub. Law 111-143). Implementation of the health information technology provisions of the American Recovery and Reinvestment Act. Efforts to reform the Medicare physician sustainable growth rate. Medicare sequestration. HR. 4302-The Protecting Access to Medicare Act of 2014 Two Midnight Rule. Recovery Audit Contractor program reform. Third Party payment of exchange premiums. HR. 546- "ACE for Kids Act" of 2015 HR. 2329- The Administrative Relief and Accurate Medicare Payments Act of 2013 HR. 1250, S. 1012- Medicare Audit Improvement Act of 2013. Florida's Medicaid Low Income Pool. Georgia's Medicaid DSH Program. Tennessee's Medicaid DSH Program. VA Healthcare Reform Legislation, general.

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Flexibility in Health IT Reporting Act of 2015 (H.R. 270) Resident Physician Shortage Reduction Act of 2013 (H.R. 1180/ S. 577) Medicare Audit Improvement Act of 2013 (H.R. 1250/ S.1012) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Medicare and Medicaid Recovery Audit Contractor (RAC) Programs Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, hospital outpatient department (HOPD) clinics, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Liver transplant allocation system FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

Client expense: $220,000 · Firm income: Not reported

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

Issues Related to Medicare inpatient and outpatient hospital payment rates H.R. 1250, Medicare Audit Improvement Act of 2013 S. 1012, Medicare Audit Improvement Act of 2013

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Site neutral payment issues; implementation of the Continuing Care Hospital; medical necessity to post-acute care reform; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; Protecting Access to Medicare Act (P.L. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act, S. 2157; H.R. 2994/S. 2553, IMPACT Act of 2014 (P.L. 113-185); Protecting Integrity in Medicare Act of 2014 (H.R. 5780); draft Hospital Improvements for Payment act of 2014; H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015; H.R. 775/S. 539 , Medicare Access to Rehabilitation Services Act of 2015

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

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

Site neutral payment issues; implementation of the Continuing Care Hospital; medical necessity to post-acute care reform; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; Protecting Access to Medicare Act (P.L. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act, S. 2157; H.R. 2994/S. 2553, IMPACT Act of 2014 (P.L. 113-185); Protecting Integrity in Medicare Act of 2014 (H.R. 5780); draft Hospital Improvements for Payment act of 2014; SGR and H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015; H.R. 775/S. 539 , Medicare Access to Rehabilitation Services Act of 2015

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

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

H.R. 2053, Medicare Access and CHIP Reauthorization Act of 2015, Issues pertaining to addressing the SGR formula, offsets for legislation and other provisions Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1250, S. 1012, Medicare Audit Improvement Act of 2013, Issues pertaining to RAC audits for hospitals. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.688, H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, Issues pertaining to adjustment for socioeconomic status in the hospital readmissions program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions; H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375 - Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920/ H.R. 5809/S. 2975 Medicare DMEPOS Competitive Bidding Improvement Act of 2014; H.R. 1516 Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015, all provisions; Complex rehab technology relating to competitive bidding; H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015, competitive bidding provisions.

Client expense: $100,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

HR 3698/ S. 2082: The Two Midnight Rule Coordination & Improvement Act HR 3993/ S. 2037: Critical Access Hospital Relief Act HR 1250/ S. 1012: Medicare Audit Improvement Act - Legislation to improve the system of hospital payment audits conducted by Medicare Recovery Audit contractors. HR 1920/ S. 1555: DSH Reduction Relief Act - Legislation to delay the Medicare & Medicaid disproportionate share hospital (DSH) cuts contained in the Affordable Care Act for two years until fiscal year 2016. HR 2801/S. 842: Protecting Access to Rural Therapy Services Act - Legislation to protect access to outpatient therapeutic services in small & rural and critical access hospitals. HR 4302: Protecting Access to Medicare Act of 2014 - Sustainable growth rate - doc. fix. HR 1201: Training Tomorrow's Doctors Act - Legislation to revise the distribution of resident positions and the calculation of payments for direct medical education costs. HR 2810/ S. 2000: Permant Sustainable Growth Rate for Medicare Physicians HR 1787/ S. 842: Rural Hospital Access Act HR 5481: Continue 3 - month quarter reporting in 2015 under Medicare & Medicaid EHR Site Neutral Payments Medicaid & Medicare Funding in the Federal Budget Medicare Payment Penalties for Hospital Aquired Conditions (HACs)

Client expense: $190,000 · Firm income: Not reported

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

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions; H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

1. Support grant funding for trauma and emergency medical services for trauma hospitals 2. H.R. 4188 and S. 2501- Readmissions policies must include socioeconomic factors 3. H.R. 1250/S. 1012-Medicare Audit Improvement Act 4. 340B Program support to maintain current level of funding and discounts 5. Medicare IPPS Rule-supported comments submited from industry associations (AHA and NJHA)

Client expense: $27,673 · Firm income: Not reported

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

1. Support grant funding for trauma and emergency medical services for trauma hospitals 2. H.R. 4188 and S. 2501- Readmissions policies must include socioeconomic factors 3. H.R. 1250/S. 1012-Medicare Audit Improvement Act 4. 340B Program support to maintain current level of funding and discounts

Client expense: $27,673 · Firm income: Not reported

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

1. Support grant funding for trauma and emergency medical services for trauma hospitals 2. H.R. 4188 and S. 2501- Readmissions policies must include socioeconomic factors 3. H.R. 1250/S. 1012-Medicare Audit Improvement Act 4. 340B Program support to maintain current level of funding and discounts

Client expense: $27,673 · Firm income: Not reported

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

1. Support grant funding for trauma and emergency medical services for trauma hospitals 2. H.R. 4188 and S. 2501- Readmissions policies must include socioeconomic factors 3. H.R. 1250/S. 1012-Medicare Audit Improvement Act 4. 340B Program support to maintain current level of funding and discounts 5. Medicare IPPS Rule-supported comments submited from industry associations (AHA and NJHA)

Client expense: $27,673 · Firm income: Not reported

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

S. 1012 / H.R. 1250: Medicare Audit Improvement Act S. 183 / H.R. 2053: Hospital Payment Fairness Act H.R. 2329: Administrative Relief and Accurate Medicare Payments Act H.R. 3698: Two Midnight Rule Delay Act S. 2082: Two-Midnight Rule Coordination and Improvement Act S. 1143 / H.R. 2801: Protecting Access to Rural Therapy Services Act H.R. 3769: Delays enforcement of physician supervision requirements for CAHs S. 2037 / H.R. 3991: Critical Access Hospital Relief Act S. 2187: Rural Community Hospital Demonstration Extension Act S. 2359: Craig Thomas Rural Hospital and Provider Equity Act H.R. 5227: Making the Education of Nurses Dependable for Schools Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose efforts to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests. Bad Debt Payments to Hospitals - Lawmakers have proposed lowering the amount of Medicare Bad Debt payments to hospitals for Medicare beneficiaries who fail to pay their cost-sharing obligations for treatments provided by the hospital. Direct and Indirect Graduate Medical Education Payments - Lawmakers have proposed changes to the way that hospitals are reimbursed for the costs of training physicians and other medical professionals. Advocate for the extension the Medicare Dependent Hospital (MDH) and current Low-Volume Hospital (LVH) programs. S. 842, the Rural Hospital Access Act of 2013 and H.R. 1787, the Rural Hospital Access Act of 2013 Oppose the lowering of Medicare outpatients rates for Evaluation and Management visits in a hospital S. 1680 - Craig Thomas Rural Hospital and Provider Equity Act of 2011 - A bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes. Oppose any cuts to the Medicaid DSH funds above and beyond what was legislated in the Affordable Care Act Support a long-term patch or full repeal of the Sustainable Growth Rate for Physician payments in Medicare that does not cut hospitals. Oppose the proposal of lowering Medicare reimbursements to Inpatient Rehabilitation Facilities. Support a reasonable one-time budget neutrality adjustment for long-term care hospitals. Sequestration - against extending the Medicare Sequester. Advocate in support of reauthorization of funding for quality measure development, endorsement, pre-rulemaking review and recommendations, and collection of data analyzing measure implementation under MIPPA (P.L. 110-275, Section 1980 ) and ACA (P.L. 111-148, Section 3014) for the consensus-based entity (National Quality Forum). H.R.1250 and S. 1012, "Medicare Audit Improvement Act of 2013" -- supports legislation to improve Medicare audits. Price Transparency - advocate for meaningful price transparency for consumers by ensuring they have access to out of pocket price information. CMS "2 Midnight" Policy - advocate for policy to allow for physician judgment on whether a patient should be considered inpatient or outpatient status, and other modifications to the policy. National Quality Forum -Advocated for inclusion of private-sector multi-stakeholder processes in development, endorsement and use of quality measures in federal payment programs under consideration. H.R. 4994 and S. 2553, "IMPACT Act of 2014"- legislation intended to improve post acute care for Medicare beneficiaries by collecting and using standardized quality data; advocate to ensure stakeholder input appropriately included in measure endorsement and review. Protecting the Integrity of Medicare Act of 2014 - Bill to combat fraud, waste and abuse in the Medicare program by streamlining processes and improving program payment accuracy. Meaningful Use - Advocate for reasonable Stage 3 meaningful use requirements as part of the EHR Incentive Program. Unique Device Identifier (UDI) - Advocate against including UDI on Medicare claims. FLEX IT ACT - HR 5481 - legislation to require CMS to implement a 90-day reporting period to qualify for incentive payments under the HITECH EHR Incentive Programs; advocate for passage of the bill in the House and introduction of a companion bill in the Senate. Provided advocacy comments regarding a House Ways and Means discussion draft, the Hospital Improvements for Payment Act of 2014 concerning hospital payment, self-referral, quality, accreditation and data release issues.

Client expense: $830,000 · Firm income: Not reported

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

HR 1201 "Training Tomorrow's Doctors Today Act" All Provisions S 577 "Resident Physician Shortage Act of 2013" All Provisions HR 574 "Medicare Physician Payment Innovation Act" All Provisions H.R. 4302 Protecting Access to Medicare Act of 2014 All Provisions P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to implementation of health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers and individuals. H.R. 1180 The Resident Physician Shortage Reduction Act of 2013. All Provisions. H.R. 1920 DSH Reduction Relief Act of 2013. All Provisions. S. 1012 The Medicare Audit Improvement Act of 2013. All Provisions. H.R. 1250 The Medicare Audit Improvement Act of 2013. All Provisions. H. R. 2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. Senate Finance Committee: The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. All Provisions. The SGR Repeal and Medicare Beneficiary Accesst Improvement Act of 2013, offered as a substitute amendment to H.R.2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. H.J. Res.59 Continuing Appropriations Resolution, 2014 Short Title: Bipartisan Budget Act of 2013 and Pathway for SGR Reform Act of 2013. All Provisions related to the Medicare Physican Payment H.R. 3698 Two-Midnight Rule Relay Act, All provision Medicare Advantage 2015 Advance Notice of Methodological Changes for Calendar Year 2015 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2015 Call Letter. All Provisions S.1932 Medicare Better Care Program. All provisions. H.R. 3890 Medicare Better Care Program. All provisions. H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act. All provisions. H.R. 1920 DSH Reduction Relief Act of 2013. All provisions. S. 2082 Two-Midnight Rule Coordination and Improvement Act of 2014. All provisions. H.R. 4673 Bundling and Coordinating Post-Acute Care Act of 2014. All provisions. H.R. 4994 Impact Act of 2014 - Improving Medicare Post-Acute Care Transformation Act of 2014. All provisions. H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act. All provisions. Medicare Shared Savings Program/Accountable Care Organizations: Potential Regulatory Reforms H.R. 5481 To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes. Hospital Improvements for Payment Act of 2014 Discussion Draft - All Provisions H.R. 5771 Tax Increase Prevention Act of 2014. All Provisions CMMI Demonstration Project

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

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

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for an additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments;AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered,and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to services furnished since January 1, 2001; S.1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions; requested that the increasing number of hospital compliance reviews performed by the Office of Inspector General (OIG) Office of Audit Services in which the OIG has extrapolated audit findings to estimate Medicare overpayments to the hospitals and the hospitals Medicare Administrative Contractors (MACs)have sought to recover the extrapolated overpayment amounts be halted without delay; Support HR 5481, The Flexibility in Health IT Reporting (Flex-It) Act, a bill to continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs. Senate briefing on legal barriers to providers' ability to manage risk, particularly with respect to Medicare ACO programs. Support HR 4656 and S2276, Caring for America's Heroes Act, a bill to improve access to mental health services under the TRICARE program; Funding for Ebola treatment and preparedness as part of the FY15 Omnibus Appropriations Act. Met to discuss the HHS calculator issue to ensure employers cannot offer health plans that exclude inpatient hospital care.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE, Veterans Affairs, Dept of (VA)

Medicare Recovery Audit Contractor (RAC) program and RAC reform proposals including H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; H.R. 2305/S. 1123 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013; H.R. 2329 - Administrative Relief and Accurate Medicare Payments Act of 2013; S.1871, the SGR Repeal and Medicare Beneficiary Access Act of 2013; and draft legislation, Protecting Integrity in Medicare Act of 2014 (PIMA); Hospitals Improvement for Payment (HIP) Act of 2014; and H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 (Public Law 113-235)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.183, Hospital Payment Fairness Act of 2013, Issues pertaining to sunsetting national budget neutrality for the hospital wage index. H.R. 2053, S. 1012, Medicare Hospital Wage Index Equity Act, Issues pertaining to changing the national budget neutrality for the hospital wage index to a state neutrality. H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1250, S. 1012, Medicare Audit Improvement Act of 2013, Issues pertaining to RAC audits for hospitals. H.R. 1920, S. 1555, DSH Reduction Relief Act of 2013, Issues regarding delaying implementation of DSH cuts. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2728, Community-Based Medical Education Act of 2014, Issues relating to concerns about reductions to IME and other items. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Recovery Audit Contractor program regulations H.R. 1250 and S. 1012 (Medicare Audit Improvement Act of 2013), all provisions

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

Government targets: HOUSE OF REPRESENTATIVES

H.R.351 - Protecting Seniors' Access to Medicare Act of 2013 H.R.574 - Medicare Physician Payment Innovation Act of 2013 H.R.647 - Achieving a Better Life Experience (ABLE) Act of 2014 H.R.1179 - Improving Access to Medicare Coverage Act of 2013 H.R.1250 - Medicare Audit Improvement Act 2013 H.R.1487 - Improved Health Care Lower Cost Act of 2013 H.R.1838 - Enhanced Access to Medicaid Services H.R.2810 - Medicare Patient Access and Quality Improvement Act of 2013 H.R.3144 - Fairness for Beneficiaries Act of 2013 H.R.4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.5460 - Medicare Ambulance Access, Fraud Prevention and Reform Act of 2014 S.313 - Achieving a Better Life Experience (ABLE) Act of 2014 S.351 - Protecting Seniors' Access to Medicare Act of 2013 S.569 - Improving Access to Medicare Coverage Act of 2013 S.755 - Enhanced Access to Medicaid Services S.1012 - Medicare Audit Improvement Act 2013 S.1871 - SGR Repeal and Medicare Beneficiary Access of 2013 S.2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2240 - Medicare Choices Empowerment and Protection Act S.2501 - Hospital Readmission Accuracy and Accountability Act

Client expense: $228,645 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Hospital and physician payments under Medicare and Medicaid, general. Medicare/Medicaid Reform - (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral) - Implementation of the Patient Protection and Affordable Care Act (Pub. Law 111-148) and the Health Care and Education Reconcilation Act of 2012 (Pub. Law 111-143).Medicare/Medicaid payments as related to the deficit reduction and debt ceiling proposals. Efforts to reform the Medicare physician sustainable growth rate. Medicare sequestration. HR 4302 - The Protecting Access to Medicare Act of 2014. Two Midnight Rule. Recovery Audit Contractor program reform. Third party payment of exchange premiums. H.R. 4930 - "Advancing Care for Exceptional Kids Actt - A childrens Medicaid bill H.R. 2329 - The Administrative Relief and Accurate Medicare Payments Act of 2013 H.R. 1250, S. 1012 - Medicare Audit Improvement Act of 2013 Florida's Medicaid Low Income Pool Georgia's Medicaid DSH Program Tennessee's Medicaid DSH Program

Client expense: $390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Health Insurance and Delivery System Reform - Implementation of the Patient Protection and Affordable Care Act (Pub. Law 111-148) and the Health Care and Education Reconciliation Act of 2010 (Pub. Law 111-143). Implementation of health information technology provisions of the American Recovery and Reinvestment Act. Efforts to reform the Medicare physician sustainable growth rate.Medicare sequestration. H.R. 4302 - The Protecting Access to Medicare Act of 2014 Two Midnight Rule. Recovery Audit Contractor program reform. Third party payment of exchange premiums. H.R. 4930 - "Advancing Care for Exceptional Kids Actt - A childrens Medicaid bill H.R. 2329 - The Administrative Relief and Accurate Medicare Payments Act of 2013 H.R. 1250, S. 1012 - Medicare Audit Improvement Act of 2013 Florida's Medicaid Low Income Pool Georgia's Medicaid DSH Program Tennessee's Medicaid DSH Program VA Healthcare Reform Legislation, general

Client expense: $390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

The Bundled Payments for Care Improvement Initiative at Center for Medicare & Medicaid Innovation; issues related to hospital quality measures. Issues related to the Hospital Prospective Payment System. Issues related to new Graduate Medical Education Residency programs. Protecting the Integrity of Medicare Act of 2014 (H.R. 5780); provisions related to healthcare providers. Bundled Payments for Care Improvement (BPCI) Program at Center for Medicare & Medicaid Innovation (CMMI); issues related to program implementation. General issues regarding Medicare claims and associated reimbursements. The Medicare Audit Improvement Act (S. 1012/H.R. 1250); provisions related to provider reimbursements. Hospital Improvements for Payment (HIP) Act of 2014; section related to the Prospective Payment System.

Client expense: $190,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014; H.R. 4302 - Protecting Access to Medicare Act of 2014; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013; S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014; S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Access Act of 2014; Graduate Medical Education Payment Issues; Implementation of the Patient Protection & Affordable Care Act (P.L. 111-148); Accountable Care Organizations/Medicare Shared Savings Program; Quality of Care Measurements/Pay for Value/Delivery System Reform; H.R. 49030 - ACE Kids Act of 2014; H.R. 3698 - The Two Midnight Delay Act of 2013; H.R. 1250/S. 1012 - The Medicare Audit Improvement Act of 2013; S. 2082 - The Two-Midnight Rule Coordination and Improvement Act of 2014; site neutral payments; post-acute care/skilled nursing facilities access; Medicare three-day rule. observation stays policies; Medicaid Primary Care Payment Parity; Home Health Care; ICD 10 Implementation; Hospital Improvements for Payment Act; Medicare Advantage Program; Postacute care.

Client expense: $110,000 · Firm income: Not reported

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

Issues concerning new GME residency programs and cancer pps-exempt hospitals; S. 1012/H.R. 1250, The Medicare Audit Improvement Act; Issues related to health information technology and transparency. Issues related to hospital reimbursement.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues concerning hospital reimbursement, two midnight rule, Medicare Recovery Audits, and specialty hospitals. Issues related to S. 1012/H.R. 1250, The Medicare Audit Improvement Act. H.R. 3698, The Two Midnight Rule Delay Act of 2013. Issues related to physician payment reform.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General background on recovery auditing; Medicare Audit Improvement Act of 2013 (S. 1012, HR 1250); issues related to recovery auditing under Medicare

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increased Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013.S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367: The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness For Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodalogy for short inpatient hospitals stays. H.R. 3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.2157: Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014. Advocacy work on HCBS proposed rule: passsed in January. S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. H.R. 1250: The Medicare Audit Improvement Act of 2013. S. 1012: Medicare Audit Improvement Act of 2013. S. 2082: The two-midnight rule coordinator and Improvement Act of 2014. Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014). Protect and Preserve Medicaid funding for Long Term Services and Supports Medicaid Provider Assessement. Improving the CMS State Plan Amdt. Process. Opposition to H.B. No. 5051 An Act Improving Transparency of Nursing Home Operations. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. Improving Medicare Post-Acute Care Transformation Act (IMPACT) Department of VA Provider Agreement proposaed rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors. MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). H.R. 4994, IMPACT Act of 2014.H.R. 5098: To amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. H.R. 5232: A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. H.R. 5373: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

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

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

**see addendum pageno specific bill - Recovery Audit Contracts, program integrity, medicare appeals, improper payments, 2 midnight policy, program waste, fraud and abuse, hospital short stays S. 1012/H.R. 1250 - Medicare Audit Improvement Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014

Client expense: Not reported · Firm income: $100,000

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

Legislative proposals affecting Medicare and Medicaid funding Proposed changes to Medicare hospital reimbursement policies Health Care Reform Implementation Graduate Medical Education - H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare inpatient and outpatient hospital payment rates H.R. 1250, Medicare Audit Improvement Act of 2013 S. 1012, Medicare Audit Improvement Act of 2013

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education, H.R. 1180 and S. 577, "Resident Physician Shortage Reduction Act of 2013" Proposed changes to Medicare hospital reimbursement policies H.R. 3698, "Two Midnight Rule Delay Act" S. 2082, "Two-Midnight Rule Coordination and Improvement Act of 2014" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, "Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policies Medicare hospital prospective payment system S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, Medicare Hospital Wage Index Equity Act" S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act - Provisions setting nurse staff ratios "Hospitals Improvements for Payment (HIP) Act of 2014" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2942, Infectious Disease Hospital Hubs Act Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Reimbursement Issues Recovery Audit Contractor Audit Issues H.R.1250/S.1012, Medicare Audit Improvement Act

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

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

Medicare and Medicaid disproportionate share hospital cuts, including DSH Reduction Relief Act - support amendments to mitigate the impact of cuts on losing hospitals, postpone Medicaid DSH cuts; Graduate Medical Education issues (including Resident Physician Shortage Reduction Act (S.577/H.R.1180) - support; Amendments to the Medicare hospital readmissions penalty program methodology (providing SES adjustments, fixing the formula flaw), H.R.4188/S.2501 - support; IMPACT Act (S.2553/H.R.4994), support reducing burdensome hospital requirements in original bill; support of final bill; Medicare Audit Improvement Act (H.R.1250/S.1012) and other issues related Medicare claims appeal backlogs - support; Proposals to amend the 2 Midnight Policy (CMS-1599-F)(H.R. 3698/S.2082) - support; comments on House Ways and Means discussion draft legislation, Hospital Improvements for Payment Act of 2014, concerns about new proposed short stay payment methdology and impact on teaching hospitals; CMS Disallowance to NYS File No.:NY-2014-03-MAP - oppose, support NYS Congressional delegation letter to CMS; legislation to create a comprehensive Medicare home infusion benefit (H.R.5435) - support; comments on physician services pertaining to non-face-to-face chronic care management services (CMS-1612-P); support NYS Congressional delegation letter to CMS on NYS State plan amendments on Medicaid rates for hospitals (2% cut restoration, Vital Access Provider funds).

Client expense: $290,000 · Firm income: Not reported

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

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare ACt of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increasd Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013.S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS) HR 4994, IMPACT Act of 2014 HR 5098 - to amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. HR 4232 - A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. HR 5373 - To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

Client expense: Not reported · Firm income: $120,000

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