SGR Repeal and Medicare Beneficiary Access Act of 2013

HR 185 - Regulatory Accountability Act - Provisions amending burdensome regulations. HR 4510/S-2270 - The Insurance Clarification Capital Standards Act - Provisions exempting insurers from Dodd-Frank Act capital requirements. HR 1090 - Retail Investor Protection Act - Provisions requiring SEC & DOL to work together before releasing rules relating to a fiduciary duty standard. HR 4302 - Protecting Access to Medicare Act of 2014 - SGR Patch S 2157 - Commonsense Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014 - SGR Repeal S 2122 - Responsible Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014 - SGR Repeal HR 4015 - SGR Repeal & Medicare Provider Payment Modernization Act of 2014 - SGR Repeal H.J. Res. 59 - Continuing Appropriations Resolution 2014 - Potential Medigap impact S 1871 - SGR Repeal & Medicare Beneficiary Access Act of 2013 - SGR Repeal HR 2810 - Medicare Patient Access & Quality Improvement Act of 2013 - SGR Repeal S.CON.Res.8 - Senate Budget FY 2014 - Potential Medigap impact H.CON.Res. 25 - House Budget FY 2014 - Potential Medigap impact HR 1478/S 798 - Policyholder Protection Act - Provisions regarding source of strength requirements. S 1484 - Financial Regulatory Improvement Act - Provisions on Federal Reserve procedures HR 2141 - The International Standards Transparency & Policyholder Protection Act - Provisions regarding regulatory consultation on domestic insurance standards. HR 3590 & HR 4872- Patient Protection & Affordable Care Act & Reconciliation - effect on home office procedures & self-insured plan, executive compensation limitation, implications to dental product. Sen. Orin Hatch report on taxes - provisions impacting the insurance & banking industries. Camp comprehensive discussion draft on tax reform - provisions impacting the insurance and banking industries.

Client expense: $129,770 · Firm income: Not reported

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

Post-acute care policy. H.R. 1179/S. 569, Improving Access to Medicare Coverage Act of 2013 H.R. 4994/S.2553 Improving Medicare Post Acute Transformation Act of 2014 S. 1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1458 BACPAC of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) H.R. 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) H.R. 4994/S 2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) H.R. 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S 1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Title II, Section 202 H.R. 5110 SAVE Medicare Home Health Act of 2014 (all sections) H.R. 3245 Medicare Home Health Fraud Reduction Act (all sections) H.R. 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 Modification of Medicare Home Health Surety Bond Condition of Participation Requirement H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015 (all sections) H.R. 1458 BACPAC of 2015 (all sections) H.R. 1250/S 1211 A bill to amend title XVIII of the Social Security Act to provide that payment under the Medicare program to a long-term care hospital for inpatient services shall not be made at the applicable site neutral payment rate for certain discharges involving severe wounds, and for other purposes (all sections) H.R. 2208 Hospice CARE (all sections) H.R. 6 21st Century Cures Act H.R. 2196/S 971 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) H.R. 441/S 202 To provide for a technical change to the Medicare long-term care hsopital moratorium exception (all sections) S 1549 Care Planning Act of 2015 (all sections) Other Issues Related to Post-Acute Care Policy

Client expense: $412,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), 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

S. 1871, the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013; S. 2157, Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; H.R. 4302, Protecting Access to Medicare Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) HR 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) HR 4994/S2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) HR 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Ttile II, Section 202 HR 5110 SAVE Medicare Home Health Act of 2014 (all sections) HR 3245 Medicare Home Health Fraud Reduction Act (all sections) Other Issues Related to Post-Acute Care Policy HR 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 Modification of Medicare Home Health Surety Bond Condition of Participation Requirement HR2 Medicare Access and CHIP Reauthorization Act of 2015 (all sections) HR1458 BACPAC of 2015 (all sections)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), 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 3590 & HR 4872 - Patient Protection & Affordable Care Act & Reconciliation Act of 2010 - effect on home office procedures, self-insured plan, executive compensation limitation. Implications to dental product. HR 185 - Regulatory Accountability Act - Provisions amending burdensome regulations. HR 1478/S 798 - Policyholder Protection Act - Source of strength requirements. Sen. Hatch Report on Taxes - provisions impacting insurance and banking industries. Camp Comprehensive Discussion Draft on Tax Reform - Provisions impacting insurance and banking industries. HR 4302 - Protecting Access to Medicare Act of 2014 - SGR Patch S 2157 - Commonsense Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014 - SGR Repeal S 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 - SGR Repeal HR 4015 - AGR Repeal and Medicare Provider Payment Modernization Act of 2014 - Potential Medigap impact. S 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 - SGR Repeal HR 2810 - Medicare Patient Access & Quality Improvement Act of 2013 - SGR Repeal S.CON.RES.8 - Senate Budget FY 2014 - Potential Medigap impact H.CON.RES.25 - House Budget FY 2014 - Potential Medigap impact HR 4510/S 2270 - Insurance Clarification Capital Standards Act - Provisions exempting insurers from Dodd-Frank Act capital requirements. HR 1090 - Retail Investor Protection Act - Provisions requiring SEC & DOL to work together before releasing rules relating to a fiduciary duty standard.

Client expense: $297,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.

Client expense: $2,010,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), 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), Government Accountability Office (GAO), 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), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare, Medicare and Medicaid Fraud, Medicare Advantage, Medicare Part D, Medicaid, Electronic Prescribing, Dual Eligibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter

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

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

no specific bill - medicare coverage and reimbursement PL 111-148 - The Patient Protection and Affordable Care Act, implementation issues related to diabetes care H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, SDP renewal H.R. 4302 - Protecting Access to Medicare Act of 2014, SDP renewal

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

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

Average Sales Price (H.R. 800, H.R. 1416, S. 806) PPACA Implementation (PL 111-148) CMS - (Sunshine, AMP and NADAC) SGR (H.R. 2810, S. 1871) Medicare Extenders (H.R. 3402) Centers For Medicare and Medicaid Services (Sunshine, AMP and NADAC)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare, Medicare Fraud, Medicare Advantage, Medicaid, Electronic Prescribing, Health Care Reform Implementation, Medigap reform, Physician Payment Reform, Delivery System Reform, medical review, ICD-10

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation, Medicare and Medicaid Drug Reimbursement, 340b, Innovation Center H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013, IPAB repeal H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, Medicare Part D, Non-Interference, health care reform implementation, AMP, Sunshine, conditions of participation

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), diagnostics, Medicare Physician Reimbursement; reimbursement for imaging and technology; value based purchasing, Accountable Care Organizations, Sunshine Act, bundling, PODs, Cost centers, ICD-10

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

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

Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, Medicare Part D Non-Interference, health care reform, drug implementation, biosimilars, 340B, Sunshine, discount cards PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014

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

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

Implementation of the Patient Protection and Affordable Care Act (PL111-148) H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill, Medicaid data, Medicare and Medicaid reimbursement policies related to health care associated conditions, health care associated infections, readmissions, payment bundling, ACOs, Sunshine, ICD-10, potentially preventable events

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

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

- Medicare coverage and reimbursement, sunshine, diagnostics H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation, care coordination, long-term care HOPE for Alzheimer's Act H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, SGR H.R. 3547 - the Consolidated Appropriations Act, 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill, Medicare coverage and reimbursement, Medicaid home and community based care, anti-psychotics, risk adjustment, Medicare Special Needs Plans

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation, ESRD, clinical laboratory payment H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013, IPAB H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), implementation of QIP and MIPPA ESRD bundling provisions, Medicare Reimbursement, Medicaid Rebate, Medicaid reimbursement, quality indicators, deficit reduction

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation, Medicare and Medicaid Reimbursement, Medicaid Rebate H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013, IPAB H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, dual eligibles, Sunshine, discount cards, MedPAC

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013, IPAB H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare Coverage, Regulation and Reimbursement of Imaging Services, Medicare Physician Payment, Sunshine Act, equipment maintenance, dose optimization

Client expense: Not reported · Firm income: $70,000

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

PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), diagnostics, Medicare Physician Reimbursement; reimbursement for imaging and technology; value based purchasing, Accountable Care Organizations, Sunshine Act, bundling, PODs, Cost centers, ICD-10

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation, Medicare and Medicaid Drug Reimbursement, 340b, Innovation Center H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013, IPAB repeal H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, Medicare Part D, Non-Interference, health care reform implementation, AMP, Sunshine, conditions of participation

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

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

Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, Medicare Part D Non-Interference, health care reform, drug implementation, biosimilars, 340B, Sunshine, discount cards PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, implementation H.R. 351/S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare, Medicare and Medicaid Fraud, Medicare Advantage, Medicare Part D, Medicaid, Electronic Prescribing, Dual Eligibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter

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

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

Average Sales Price (H.R. 800, H.R. 1416, S. 806) PPACA Implementation (PL 111-148) CMS - (Sunshine, AMP and NADAC) SGR (H.R. 2810, S. 1871) Medicare Extenders (H.R. 3402) Centers For Medicare and Medicaid Services (Sunshine, AMP and NADAC)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

no specific bill - medicare coverage and reimbursement PL 111-148 - The Patient Protection and Affordable Care Act, implementation issues related to diabetes care H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, SDP renewal H.R. 4302 - Protecting Access to Medicare Act of 2014, SDP renewal

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013, SGR S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 ***, no specific bill(s), Medicare, Medicare Fraud, Medicare Advantage, Medicaid, Electronic Prescribing, Health Care Reform Implementation, Medigap reform, Physician Payment Reform, Delivery System Reform, medical review, ICD-10

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

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

H.R. 713/S. 367-Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) Payments to Physical Therapists under the Medicare Physician Fee Schedule Permanent Repeal of/alternatives to the Sustainable Growth Rate (SGR) Formula H.R. 574 Medicare Physician Payment Innovation Act Opposition of Multiple Procedure Payment Reduction for PT Services Physician Quality Reporting System H.R. 2914 Promoting Integrity in Medicare Act H.R. 1310 and S. 236 Medicare Patient Empowerment Act Prevention Initiatives for Fraud and Abuse in the Medicare program Accountable Care Organizations/Patient Centered Medical Homes Electronic Health Records/ Health Information Technology incentives for Physical Therapists Development of Alternatives to Medicare Therapy Cap Medicare Payment Reform Local Coverage Determinations NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National Priority for Research and Research Agenda Health Information Technology Medicare Physician Payment Innovation Act Functional Limitation Reporting Therapy Cap: Manual Medical Review Essential Health Benefits Sustainable Growth Rate Reform H.R. 1179/S. 569 Improving Access to Medicare Coverage Act Medicaid Essential Health Benefits EHR/LTPAC Settings: Transitions of Care Medicare Improvement Standards Bundled Payment Models Common assessment tool for Medicare post-acute care Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act/S.2818 H.R. 942 and S. 948 Ensuring Access to Quality Complex Rehabilitation Technology H.R. 2810 Medicare Patient Access and Quality Improvement Act Inclusion of physical therapists in quality programs in SGR Reform H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 FTC Anti-competition Self-referral S.1871 SGR Repeal and Medicare Beneficiary Access Act S.2110 Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2157 Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act H.R.4302 Protecting Access to Medicare Act Statement for the record on Ways and Means Health Subcommittee Current Hospital Issues in Medicare H.R. 4755 Access to In-patient Rehabilitation Therapy Act H.R. 4994/S.2553 IMPACT Act Able Act Comments on CY2015 OPPS rule H.R. 5380 Medicare Telehealth Parity Act Comments on draft Fraud & Abuse Legislation Hospital Improvements for Payment Act H.R. 5380 Medicare Telehealth Parity Act

Client expense: $308,338 · Firm income: Not reported

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

S. 2461, CHIP Extension Act of 2014 S. 425/H.R. 896, Quality Care for Moms and Babies Act S. 2434/HR 4865, Family Coverage Act Affordable Care Act Implementation pertaining to women and children Medicaid Children's Health Insurance Program reauthorization health care quality issues pertaining to women and children health coverage for immigrant pregnant women and children S. 1871, The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013, provisions/amendments related Medicaid, quality measures and Children's Health Insurance Program

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), SENATE, Treasury, Dept of, U.S. Postal Service (USPS)

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

H.R. 1201- Training Tomorrow's Doctors Today; Graduate Medical Education provisions S. 577, H.R. 1180- Resident Physician Shortage Reducation Act Hospital Evaluation and Management site-neutrality payment proposal H.R. 1920- DSH Reducation Relief Act of 2013 H.R. 1787, S. 842- Rural Hospital Access Act of 2013; Critical Access Hospitals S. 1143, H.R. 2801- Protecting Access to Rural Therapy Services Act- provisions re "direct supervision" at Critical Access Hospitals S. 1871- SGR Repeal and Medicare Beneficiary Access Improvement Act; Medicare Sustainable Growth Rate provisions and "general supervision" provisions for rural and Critical Access Hospitals H.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077-Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2014 H.R. 5558- ACO Improvement Act H.R. 4851- FLEX-IT Act; provsions related to "Meaningful Use"

Client expense: Not reported · Firm income: $5,850

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

Medical privacy; general issues. Standards for health care technology and medical devices; general issues. Interoperability of health information and health IT management; general issues. S. 1871 SGR Repeal and Medicare Beneficiary Access Act of 2013; issues related to interoperability of health records, access to CMS data and telemedicine. H.R. 2810 Medicare Patient Access and Quality Improvement Act of 2013; issues related to interoperability of health records, access to CMS data and telemedicine. H.R. 4209 SGR Repeal and Medicare Provider Payment Modernization Act of 2014; issues related to telemedicine, data transparency, and interoperability. H.R. 4870 Defense Appropriation Bill; issues pertaining to electronic health records. H.R. 4486 Military Construction/Veterans Appropriations; issues pertaining to electronic health records.

Client expense: $1,520,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Security Agency (NSA), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmission, payment bundling, and potentially preventable events. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) User Fee Program H.R.523-Protect Medical Innovation Act of 2013 S.232 - Medical Device Access and Innovation Protection Act Klobuchar / Hatch amendment #297 to S. Con. Res 8, the Senate FY 2014 Budget Resolution to support repeal of the medical device tax H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act H.R.5823 - Incentivizing Healthcare Quality Outcomes Act of 2014

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconcilation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmissions, payment bundling, and potentially preventable events. Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act H.R.5823 - Incentivizing Healthcare Quality Outcomes Act of 2014

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

H.R. 1201- Training Tomorrow's Doctors Today; Graduate Medical Education provisions S. 577, H.R. 1180- Resident Physician Shortage Reducation Act Hospital Evaluation and Management site-neutrality payment proposal H.R. 1920- DSH Reducation Relief Act of 2013 H.R. 1787, S. 842- Rural Hospital Access Act of 2013; Critical Access Hospitals S. 1143, H.R. 2801- Protecting Access to Rural Therapy Services Act- provisions re "direct supervision" at Critical Access Hospitals S. 1871- SGR Repeal and Medicare Beneficiary Access Improvement Act; Medicare Sustainable Growth Rate provisions and "general supervision" provisions for rural and Critical Access Hospitals H.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077-Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2014 H.R. 5558- ACO Improvement Act H.R. 4851- FLEX-IT Act; provsions related to "Meaningful Use"

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 2810, SGR Repeal and Medicare Beneficiary Improvement Act of 2013 S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013 S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access improvement Act of 2014 S. 2157, Commonsense Medicare SOR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 603, Jobs and Premium Protection Act H.R. 1960, National Defense Authorization Act for Fiscal Year 2014 S. 1034, National Defense Authorization Act for Fiscal Year 2014 H.J.RES.5, Proposing an amendment to the Constitution of the United States relative to balancing the budget S. 2173, CHOICE Act, to amend the Patient Protection and Affordable Care Act to provide a permanent path for the direct enrollment of individuals in qualified health plans S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 430, The Protecting Access to Medicare Act

Client expense: $128,894 · Firm income: Not reported

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

HR 487, Primary Care Workforce Access Improvement Act, Urge House to cosponsor bill that would create GME pilot project to train primary care doctors, urge Senate to sponsor bill. HR 1281, Newborn Screening Saves lives Reauthorization Act, Supporting parent and provider newborn screening education programs and research at NIH. HR 487, Primary Care Workforce Access Improvement Act, Urge House to cosponsor bill that would create GME pilot project to train primary care doctors, urge Senate to sponsor bill. HR 1281, Newborn Screening Saves lives Reauthorization Act, Supporting parent and provider newborn screening education programs and research at NIH. HR 2642, 5-year Farm Bill, FDA, tobacco regulation and nutrition programs. HR 2810, Repeal of Medicare SGR formula, Repeal of SGR to be replaced by a positive payment update and higher rate for primary care, Medicare Physician Payment rate and implementation of alternative payment models. HR 3547, Promoting Teaching Health Centers, AHRQ, Title VII primary care grants and NHSC appropriations, AAFP budget priorities, Title VII Sec 747, Teaching Health Center grants, NHSC, AHRQ. HR 4302 (SGR patch legislation), Advocate for inclusion of policies that benefit primary care, e.g. 9-month length. HR 4302, Protecting Access to Medicare Act, Medicare physician payment rate extended for one year. S. 1759, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 1871, SGR Repeal and Medicare Beneficiary Access, Medicare Physician Payment rate and implementation of alternative payment models. S. 1978, Increasing Primary Care Access Act, Family physician workforce. S. 2000, SGR repeal and Medicare provider Payment Modernization, Medicare Physician Payment rate and implementation of alternative payment models. S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act, Medicare Physician Payment rate and implementation of alternative payment models. S. 2157, the commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act, Medicare Physician Payment rate and implementation of alternative payment models. No Bill Number, SGR Repeal and Replacement process, Advocate for SGR repeal and new physician payment system that pays for value and primary care. No Bill Number, Medicaid Primary Care Bonus, Advocate for extension of the Medicaid bonus which expires at the end of 2014; advocate for members to mention at E&C hearing. No Bill Number, Telemedicine, educate staff on AAFP's view of telemedicine policies. No Bill Number, Rural physician workforce, Access to care in rural areas; Increased family physician workforce. No Bill Number, Call for an end to sequestration, End accross-the-board cuts to Medicare, NHSC, CHC, primary care research and training. No Bill Number, AHRQ 15th anniversary, Promoting primary care research. No Bill Number, President's FY 2015 budget, Federal spending prioritiesto support workforce, research. No Bill Number, AHEC Title VII section 751 program, Family physician workforce. No Bill Number, Coalition meetings to promote Medicaid parity payment, extend Medicaid parity for primary care. No Bill Number, HRSA budget, promoting health care access and increase physician workforce. No Bill Number, Medicare physician payment reform of the SGR, 2014 conversion factor. No Bill Number, E-Cigarettes, Urge FDA to regulate all tobacco products. No Bill Number, Graduate Medical Education, Nominate FP's to Council on GME. No Bill Number, Health insurance marketplaces, concerns with 90-day grace period. No Bill Number, Anti-competitive aspects of healthcare, FTC hearing and request for comments on professional regulations role. No Bill Number, Part D formularies, Opposed CMS changes to Part D formularies. No Bill Number, Nomination of Dr. Vivek Murthy for Surgeon General. No Bill Number, Tobacco Cessation Programs, Asking HHS to clearly define a comprehensive tobacco cessation benefit in health insurance coverage. No Bill Number, FY 2015 Federal Budget Proposal, Supporting budget proposals for primary care research, education and training programs. No Bill Number, Competition in Health Care Industries, Recommending state oversight in health care scope of practice and FTC oversight of hospital and insurance consolidations. No Bill Number, Notification of Lapsed Payment of Health Care Insurance Premiums, Revising policy to have insurance plans notify physicians that a patient has not paid on-month's premium. No Bill Number, Primary Care Incentive Payment Revision, Monitoring MedPac recommendation to make PCIP a capitated payment. No Bill Number, First Fridays Meetings, Provider outreach group for Affordable Care Act issues. No Bill Number, FTC Healthcare Competition Workshop, Scope of Practice issues. No Bill Number, Hearing of Energy and Commerce Subcommittee on Oversight and Investigations, Implementation of the Affordable Care Act's Health Insurance Marketplaces. No Bill Number, Energy and Commerce Health Subcommittee Hearing on drug shortages, reducing the incidence of local and regional shortage of drugs. No Bill Number, Energy and Commerce Subcommittee on Oversight and Investigations - Hearing on Counterfeit drugs. No Bill Number, Energy and Commerce Subcommittee on Commerce, Manufacturing and Trade - hearing on Sports safety.

Client expense: $629,961 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Small Business Administration (SBA), White House Office

HR 487, Primary Care Workforce Access Improvement Act, Urge House to cosponsor bill that would create GME pilot project to train primary care doctors, urge Senate to sponsor bill; urge W&M offices to discuss during March 2014 budget hearing. HR 2810, Repeal of Medicare SGR formula, Repeal of SGR to be replaced by a positive payment update and higher rate for primary care. Medicare Patient Access and Quality Improvement Act, Medicare Physician paymnent rate and implementation of alternative payment models. HR 4302 (SGR patch legislation), Advocate for inclusion of policies that benefit primary care, e.g. 9-month length, Protecting Access to Medicare Act, prevent 24 percent cut medicare physician payment. HR 4302 (PL-113-93), Protecting Access to Medicare Act, Medicare physician payment rate extended for one year. S. 1759, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 1871, SGR Repeal and Medicare Beneficiary Access, Medicare Physician Payment rate and implementation of alternative payment models. S. 2000, Repeal Medicare Sustainable Growth Rate, Repeal SGR. Positive update and higher rate for primary care, Medicare Physician Payment rate and implementation of alternative payment models. S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act, Medicare Physician Payment rate and implementation of alternative payment models. S. 2157, the commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act, Medicare Physician Payment rate and implementation of alternative payment models. No Bill Number, SGR Repeal and Replacement process, Advocate for SGR repeal and new physician payment system that pays for value and primary care. No Bill Number, Medicaid Primary Care Bonus, Advocate for extension of the Medicaid bonus which expires at the end of 2014. No Bill Number, Call for an end to sequestration, End accross-the-board cuts to Medicare, NHSC, CHC, primary care research and training. No Bill Number, AHRQ 15th anniversary, Promoting primary care research. No Bill Number, President's FY 2015 budget, Federal spending priorities to support workforce, research; Supporting budget proposals for primary care research, education and training programs. No Bill Number, Coalition meetings to promote Medicaid parity payment, extend Medicaid parity for primary care. No Bill Number, AHEC Title VII section 751 program, Family physician workforce. No Bill Number, Medicare physician payment reform of the SGR, 2014 Proposed Medicare physician fee schedule. No Bill Number, Conversion to ICD-10, Urged HHS to delay and test ICD-10 before requiring it. No Bill Number, Medicare Part-D Formulary, Opposing regulation that would eliminate protected statuys of antidepressants and antipsychotics in the Part D formulary. No Bill Number, Notification of Lapsed Payment of Health Insurance Premiums, Revising policy to have insurance plans notify physicians that a patient has not paid one month's permium. No Bill Number, Primary Care Incentive Payment Revision, Monitoring MedPAC recommendation to make PCIP a capitated payment. No Bill Number, Extend Medicare/medicare parity for primary care services, Extend increase in Medicaid payments for primary care services to Medicare levels beyond 2015. No Bill Number, Coalition meetings to promote Medicaid parity payment, Extend Medicaid parity for primary care. No Bill Number, Hearing of Energy and Commerce Subcommittee on Oversight and Investigations, Implementation of the Affordable Care Act's health Insurance Marketplaces. No Bill Number, Rural Physician Workforce, Access to care in rural areas; increased family physician workforce.

Client expense: $629,961 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Small Business Administration (SBA), White House Office

S. 1871, the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013; S. 2157, Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; H.R. 4302, Protecting access to Medicare Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACE Kids Act (H.R. 4930) Better Care, Lower Cost Act (Wyden) (S.1932) CMS Request for Comments: Enhancements to the Star Ratings for 2016 and Beyond Medication AdherenceMedicare Access to Rehabilitation Services Act (H.R. 713/S.367) Medicare Diabetes Prevention Act (S. 452) Medicare SGR Reform (Senate Finance draft, House Ways & Means draft) Medicare SGR Repeal & Beneficiary Access Improvement Act (S.2110) Medication Therapy Management Act of 2013 (H.R. 1024/S.557) Pathway for SGR Reform Act (temporary extension of Medicare extenders) (H.J. Res.59) 2015 Physician Fee Schedule (CMS-1612-P) Protecting Access to Medicare Act (H.R.4302) Recruiting Individuals to Drive our Elders (RIDE) Act-not yet introduced SGR Repeal and Medicare Beneficiary Access Act (S.1871& H.R.2810) Telehealth Enhancement Act (H.R.3306/ S.2662)

Client expense: $176,171 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), 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), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

please see addendum H.R. 1331 the Electronic Health Records Improvements Act H.R. 1201 Training Tomorrow's Doctors Today Act H.R. 1701 Cutting Costly Codes Act of 2013 H.R. 1827 The Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R.2545 Accuracy in Medicare Physician Payment Act of 2013 H.R. 2720 The Alexis Agin Identity Theft Protection Act H.R. 2810 Medicare Patient Access and Quality Improvement Act S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act S. 577 The Resident Physician Shortage Act S. 1180 Medicare Data Access for Transparency and Accountability Act S. 1360 The Improper Payments Agency Cooperation Enhancement Act S. 1871 SGR Repeal and Medicare Beneficiary Access Act of 2013 Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Sustainable Growth Rate, Medicare Physician Payment Reform, Independent Payment Advisory Board, Resident work hours, patient centered outcomes research institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ-USPSTF, Graduate Medical Education, Medical Loss Ratio, Electronic cigarette regulation, surgical global payments

Client expense: $110,000 · 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), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)