Better Care, Lower Cost Act

General briefings to government officials on the status of Molycorp's vertically integrated rare earth manufacturing supply chain; production increases the Mountain Pass Rare Earth Facility; technology trends related to rare earth permanent magnetic materials; and the potential for rare earth materials to be used in clean energy, advanced transportation, energy efficiency, and other technologies. -- H.R. 4435, National Defense Authorization Act for Fiscal Year 2014, issues related to strategic materials such as rare earth elements -- S. 1932, Energy Savings and Industrial Competitiveness Act of 2014, issues related to strategic materials and advanced, high-efficiency motors that utilize rare earth elements -- S. 2006, National Rare Earth Cooperative Act of 2014, issues related to rare earth resources and production technologies -- S.1600, Critical Minerals Policy Act of 2013, issues related to rare earth resources and production technologies

Client expense: $84,000 · Firm income: Not reported

Government targets: Central Intelligence Agency (CIA), Commerce, Dept of (DOC), Defense Intelligence Agency (DIA), Defense Logistics Agency, Defense, Dept of (DOD), Energy, Dept of, HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

S 367/HR 713 - Medicare Access to Rehabilitation Services Act: Advocate for removal of cap on occupational therapy services and passage. HR 942/S 948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013: Advocate for inclusion of occupational therapy professionals as providers of complex rehabilitation technology. No bill# - Educate about role of occupational therapy in primary care. HR 2810 - The Medicare Patient Access and Quality Improvement Act of 2013: Advocated regarding sustainable growth rate and educate about the role of occupational therapy in health care and need for improving Medicare to assure that patients receive appropriate care, especially occupational therapy services, and that payment is fair and equitable. No bill# - Multiple Procedure Payment Reduction (MPPR): Advocate the separation of occupational therapy from physical therapy/speech language pathology in application of MPPR policy. No bill# - Manual Medicare Review (MMR: Advocate for improved MMR procedures including electronic submission and 10 day turn around. S 1871/S 2110 - the Sustainable Growth Rate (SGR) Repeal and Medicare Beneficiary Access Improvement Act of 2013 AND HR 4015/S 2000 - SGR Repeal and Medicare Provider payment Modernization Act of 2014: Advocated for improvements to the bills that address policies that pertain to beneficiaries' access to occupational therapy services and how occupational therapy services are reimbursed under the Medicare program. Advocate for repeal of the Medicare Part B outpatient therapy cap on occupational therapy services. HR 3749 - The Medicare Demonstration of Coverage for Low Vision Devices Act: Support for greater attention to low vision coverage and highlight role of occupational therapy in ensuring the devices are utilized properly and to their full potential. S 1932/HR 3890 - Better Care, Lower Cost Act: Educate about role of occupational therapy in helping people with chronic conditions. Support including occupational therapy in the chronic care innovation centers. HR 4994/S 2553 0 The Improving Medicare post-Acute Care transformation Act of 2014 "IMPACT Act of 2014": Advocated for improvements in the bill that would help ensure Medicare beneficiaries' access to quality post-acute care in the right setting is preserved. Advocated to ensure data collection program includes elements that reflect the contributions of occupational therapy across the various post-acute settings. HR 5380 - Medicare Telehealth Parity Act: Support passage and inclusion of occupational therapy services. HR 3306 - The Telehealth Enhancement Act of 2013: educate about how occupational therapy can be utilized in telehealth. HR 3877 - Lymphedema Treatment Act: Support passage and educate about role of occupational therapy services. No. bill# (PL 113-93) - Advocate for inclusion of occupational therapy in the Excellence in Mental Health Act's Medicaid Demonstration by encouraging Members of Congress to send a letter of support to the Substance Abuse and Mental Health Administration. HR 5547/S 2515 - Community Integration Act: Discussed Act's aims to strengthen Medicaid beneficiaries' opportunities to receive home and community-based services. Met with staff from the Health Resources and Services Administration (HRSA), including Dr. Marcia Brand, HRSA Deputy Administrator, along with other representatives of allied health professionals, to discuss recent restructuring of HRSA that appears to deemphasize allied health professions and lack of funding for allied health training programs. Also discussed the need to clearly define "allied health professionals" both for existing policies and new programs being developed at the Centers for Medicare and Medicaid Innovation; and the role of allied health professionals in the changing health care landscape.

Client expense: $200,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), 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

HR 487, Primary Care Workforce Access Improvement Act; pilot test alternatives to GME payment in order to increase primary care physician training.HR 2415, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. HR 3230, Veterans Access, Choice and Accountablility Act; Support for allowing family physicians to provide health care to veterans paid for by the VHA. HR 4015, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. HR 4292, The Underserved Veterans Access to Healthcare Act; support for primary care residency positionsin VA health system. HR 5481, Health IT-FLEX-IT Act, Urge leadership and member offices to support bill during lame duck session- bill would shorten 2015 reporting period for meaningful use. HR 5498, Primary Care Physician Reentry Act, Facillitate reentry into practice for primary care physicians. HJ Res. 124, the Continuing Resolution; Support for continued funding for Health Professions Grants and other discretionary programs for primary care. S. 1184, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. S. 1759, Reauthorizing Teaching Health Center GME Program, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 1932, the Better Care at Lower Cost Act, Support for chronic care management. S. 1978, Reauthorizing Teaching Health Center GME Program, Reauthorize the Teaching Health Centers Graduate Medical Education program; Increasing Primary Care access Act, Family physician workforce. S. 2000, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. S. 2229, Reauthorizing Teaching Health Center GME Program, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 2694, Medicaid Parity for Primary care, including S. 2694, advocate for extension of parity which expires at the end of 2014; urge Senators to co-sponsor S. 2694. S. 2728, Extending and increasing funding for grants to teaching health centers. No Bill Number, Graduate Medical Education, Explain and advocate for AAFP's newly released policy proposals on GME; Support for primary care residency slots in non-hospital; settings. 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, National Health Service Corps trust fund reauthorization, appropriation, NHSC provides scholarships & debt relief as well as physicians for underserved communities. No Bill Number, Patient Safety and Primary Care Research, Patient safety and primary care research at AHRQ. No Bill Number, FY funding increses in AHRQ, Title VII 747, NHSC, Teaching Health Center planning grants, Federal spending priorities to support workforce, research. No Bill Number, Advisory Committee on Training in Primary Care Medicine and Dentistry, Federal spending on primary care medicine training grants. No Bill Number, Increased funding for Title 747, Federal spending on primary care medicine training grants. No Bill Number, Joining Forces Mental Health Convening, mental health care for returning service members & families. No Bill Number, Increased funding for AHRQ, Federal spending on patient safety primary care research. No Bill Number, Ebola Public Health Threat, Family Physician Kent Brantly testified at Senate hearing. No Bill Number, Medicare EHR incentive payments, Concerns over attestation process. No Bill Number, Infection Advisory, Nominated a FP to a panel. No Bill Number, Medicare physician payment, Comments of 2015 proposed payments. No Bill Number, Medicaid advisory panel, Nomiated FPs to MACPAC. No Bill Number, Physician relative value units, Comments on proposed review of RVUs by CMS. No Bill Number, Tobacco delivery devices, Urged FDA to assert authority. No Bill Number, Continuing Medical Education, Urged CMS to not change Open Payment CME policy. No Bill Number, Food Safety Modernization Act, Support for regulation to prevent food-borne illnesses. No Bill Number, Adult Pneumococcal Vaccine, Support for Medicare payment to administer PCV13.No Bill Number, Health Insurance Marketplace Issues & Provider Involvement with Patient Enrollment, Network adequacy,Patient Enrollment in Marketplaces. No Bill Number, E-Cigarettes, Support of FDA proposed rule giving the agency authority to regulate e-cigarettes. No Bill Number, Medicare Physician Payment Proposed Rule; Support for payment strategies that recognize primary care and care coordination.

Client expense: $666,947 · 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), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 487, Primary Care Workforce Access Improvement Act, pilot test alternatives to GME payment to increase PCP training.HR 2415, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. HR 5481, Health IT-FLEX-IT Act, Urge leadership and member offices to support bill during lame duck session- bill would shorten 2015 reporting period for meaningful use. HR 4015, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. S. 1184, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. S. 1759, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 1978, Increasing Primary Care Access Act, Family physician workforce, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 1932, the Better Care at Lower Cost Act, Support for chronic care management. S. 2000, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. S. 2229, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 2694, Medicaid Parity for Primary care, including S. 2694, advocate for extension of parity which expires at the end of 2014; urge Senators to co-sponsor S. 2694; Ensuring Access to Primary Care for Women and Children Act, Prevent Medicaid primary care physician pay cut; Support for extension of this provision to pay primary care physicians for primary care services; extend increase in Medicaid payments for primary care services to Medicare levels beyond 2015; Seek House companion legislation. S. 2728, Community-based Medical Education Act of 2014, Medicare GME reform and THC GME reauthorization; Extending and increasing funding for grants to teaching health centers. 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, Graduate Medical Education, Explain and advocate for AAFP's newly released policy proposals on GME. No Bill Number, Medicare Graduate Medical Education, Medicare GME Reform. No Bill Number, Medicare EHR incentive payments, Concerns over attestation process. No Bill Number, Medicare physician payment, Comments of 2015 proposed payments. No Bill Number, Medicare Physician Payment Proposed Rule; Support for payment strategies that recognize primary care and care coordination. No Bill Number, Graduate Medical Education, Support for primary care residency slots in non-hospital settings. No Bill Number, Adult Pneumococcal Vaccine, Support for Medicare payment to administer PCV13. No Bill Number, Pharmaceutical Companies' Payments to Physicians; Support for keeping payments for continuing education excluded from reporting. No Bill Number, Meaningful Use of Health Information Technology Requirements, Support for 90-day EHR reporting period for 2015. No Bill Number, Narrow Networks, Support for restricting health plans' ability to disassociate with primary care physicians. No Bill Number, Repeal SGR, Positive update and higher rate for primary care.

Client expense: $666,947 · 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), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Preventing reductions to Medicare physician payment; Reforming the sustainable growth rate formula: "The SGR Repeal and Medicare Provider Payment Modernization Act of 2014" (S 2000/HR 4015); Preventing cuts to Medicare Graduate Medical Education and Disproportionate Share Hospital Payments; Preventing reductions to Hospital Inpatient and Outpatient PPS Payments; Provider reimbursements for end of life care counseling: "Personalize Your Care Act of 2013" (HR 1173); Medicare reimbursements for molecular diagnostics; Medicare coding & reimbursement associated with Screening, Brief Invention and Referral to Treatment; Additional Medicare support for Medicare Graduate Medical Education by expanding Medicare resident limits: "Training Tomorrows Doctors Today Act" (HR 1201), "The Resident Physician Shortage Reduction Act of 2013" (HR 1180), "The Resident Physician Shortage Reduction Act of 2013" (S 577), "Community-Based Medical Education Act of 2014 (S 2728); Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health services for Medicare patients: "Home Health Care Planning Improvement Act (HR 2504, S 1332); Medicare payment for chronic care: "Better Care, Lower Cost Act of 2014" (S 1932); Medicare payment for short hospital stays: "Two- Midnight Rule Coordination and Improvement Act of 2014" (S 2082); Critical Access Hospital Relief Act (HR 3991/S. 2037); Improving the Medicare hospital readmissions program: "The Establishing Beneficiary Equity in the Hospital Readmission Program Act" (HR 4188); Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children, "Advancing Care for Exceptional Kids Act of 2014" (HR 4930).

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

Government targets: HOUSE OF REPRESENTATIVES, 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)

HR 2375 -Transparency and Accountability in Medicare Bidding Act of 2013 - provisions related to Round One recompete and implications for diabetes products. HR 2810 - The Medicare Patient Access and Quality Improvement Act of 2013 - issues related to reform of the physician fee schedule and the SGR formula.Provided continuing support for Medtronic acquisition of Covidien, which included attention to potential legislation on federal contracting limitations and various tax policy proposals. H.R. 2725 - FDA Safety Over Sequestration Act of 2013, and S. 1413 FDA User Fee Protection Act - provisions related to protecting industry paid user fees from sequestration H.R. 2663 & S. 1422 - The Preventative Health Savings Act - provisions that will permit leaders in Congress to request that CBO estimate the long-term health savings that are possible from preventative health initiatives like abdominal aortic aneurysm, hypertension screenings. H.R. 3077 The TELE-MED Act of 2013 provisions related to telemedicine and remote monitoring that increase access to health care and enhance patient outcomes H.R. 3303 Software Act of 2013 - provisions related to FDA regulation of health information technology and mobile medical applications S. 1932 - Better Care, Lower Cost Act - provisions related to management of chronic disease H.R. - 3890 - Better Care, Lower Cost Act - provisions related to management of chronic disease Issues related to neuroscience research Issues related to the discovery, development and delivery of promising new treatments to patients (21st Century Cures).

Client expense: $950,000 · 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. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs 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;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 financing for infectious disease such as Ebola; and other issues relating to health care reform implementation. *AddMACPACtoAgencyList

Client expense: $2,230,000 · 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 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), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

(1) Issues related to Public Law 111-148 - The Patient Protection and Affordable Care Act (provisions related to Medicaid and Medicare); (2) Issues related to Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 (provisions related to Medicaid and Medicare); (3) Issues pertaining to entitlement reform, Medicare Advantage, Medicaid Dual Eligibles, and Medicare reimbursement and enrollment; (4) Issues related to S. 1932 - Better Care, Lower Cost Act; (5) Issues related to H.R. 4302 -Protecting Access to Medicare Act, and Rate Notice; and (6) Issues related to S. 1871 - The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013; (7) Issues related to S. 2461 CHIP Extension Act of 2014; (8) issues related to H.R. 4994 Improving Medicare Post-Acute Care Transformation Act of 2014; and (9) Issues related to H.R.5771 Tax Increase Prevention Act of 2014.

Client expense: $1,030,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

S. 557, The Medication Therapy Management Empowerment Act of 2013 H.R. 1024, The Medication Therapy Management Empowerment Act of 2013 H.R. 2810, Medicare Patient Access and Quality Improvement Act The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 H.R.4302 - Protecting Access to Medicare Act of 2014 H.R. 4190 - To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. H.R. 3890 / S. 1932 - Better Care, Lower Cost Act H.R.4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014

Client expense: $460,000 · Firm income: Not reported

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

S. 1932 - Better Care, Lower Cost Act H.R. 3890 - Better Care, Lower Cost Act H.R. 1666 -the Patient Centered Quality Care for Life Act. H.R. 1339 - the Palliative Care and Hospice Education and Training Act S. 641-the Palliative Care and Hospice Education and Training Act

Client expense: $460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs. 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare physician payment; Medicare coverage; Medicare hospital payment; physician and hospital quality; medical liability reform; electronic health record incentive program; clinical data registries; graduate medical education; health care quality; medical imaging and prior authorization; in-office ancillary services exception. HR 2914, Promoting Integrity in Medicare Act; SGR Repeal and Beneficiary Access Improvement Act; HR 4015/S 2000, SGR Repeal and Medicare Provider Payment Modernization Act; S 2501, Hospital Readmission Accuracy and Accountability Act; S 1932/HR 3890, Better Care, Lower Cost Act; Facilitating Participation in Clinical Data Registries Act; IMPACT Act; S 2552, Medicare Advantage Participant Bill of Rights Act; HR 4282, CARE Act; HR 4930, Advancing Care for Exceptional Kids Act; S 961/HR 36, Health Care Safety Net Enhancement Act; HR 5215, to provide for recommendations for the development and use of clinical data registries; HR 5481, FLEX-IT Act; HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act; HR 4857, Ensuring Equal Access to Treatments Act; S 1758, Quality Data, Quality Healthcare Act; HR 4418, Expanding the Availability of Medicare Data Act; Hospital Improvements for Payment (HIP) Act of 2014; Protecting Integrity in Medicare Act of 2014 (PIMA); HR 647, ABLE Act; S 2461/HR 5364, CHIP Extension and Improvement Act of 2014.

Client expense: $410,000 · Firm income: Not reported

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

S. 867 -- Medicare Prescription Drug Program Integrity and Transparency Act; Implementation of H.R. 3204 - the Drug Quality and Security Act (P.L. 113-54); S. 557/H.R.1024 -- the Medication Therapy Management Empowerment Act of 2013; S. 1932/H.R. 3890 -- the Better Care, Lower Cost Act. S. 2253 -- the Health Care Fairness and Stability Act. H.R. 3489 -- to amend section 1341 of the Patient Protection and Affordable Care Act to repeal the funding mechanism for the transitional reinsurance program in the individual market, and for other purposes. H.R. 4190 -- amend Title XVIII of the Social Security act to provide for coverage under the Medicare program of pharmacist services. Health care reform implementation issues; Regulatory developments, including value-based design issues as they relate to preventative care.

Client expense: $150,000 · 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 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

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2753 Securing Care for Seniors Act: Provisions related to Value Based Insurance Design H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to Office of Inspector General (OIG) enforcement of fraud and abuse laws H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 3890 Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to sustainable growth rate (SGR) and Medicare provider payment reform H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014: Provisions related to Part D preferred pharmacy networks H.R. 5183, Value Based Insurance Design for Better Care Act of 2014: Provisions related to valued base insurance design demonstration program H.R. 5558 ACO Improvement Act: Provisions related to alternate payment models H.R. 5780, Protecting Integrity in Medicare Act of 2014: Provisions related to addressing fraud and prescription drug abuse S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 557, Medication Therapy Management Empowerment Act of 2013: Provisions related to Part D and medication therapy management S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Hospital Improvements for Payment (HIP) Act of 2014: Provisions related to Medicare reform (no bill number) Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence

Client expense: $3,960,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Patent & Trademark Office (PTO), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 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 Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 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 Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), 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: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

HR 2190 & S 1206 - Medicare Drug Savings Act of 2011: To amend title XVIII of the Social Security Act to require drug manufacturers to provide drug rebates for drugs dispensed to low-income individuals under the Medicare prescription drug benefit program. HR 2753 - Securing Care for Seniors Act of 2013: To amend title XVIII of the Social Security Act to improve Medicare Advantage and for other purposes. HR 2810 - Medicare Patient Access and Quality Improvement Act of 2013: Amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians services and for other purposes. HR 3077 - TELE-MED Act of 2013: Amend title XVIII of the Social Security Act to permit certain Medicare providers licensed in a state to provide telemedicine services to Medicare beneficiaries in a different state. HR 3890 - Better Care Lower Cost Act: 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. HR 4160 - Keep the Promise to Seniors Act of 2014: To prohibit further action on the proposed rule regarding change to the Medicare prescription drug benefit program. HR 4998 - Medicare Advantage Participation Bill of Rights Acts of 2014: To enhance beneficiary and provider protections and improve transparency in the Medicare Advantage market and for other purposes. HR 5183 & S 2783 - Value Based Insurance Design for Better Care Act of 2011: To establish a demonstration program requiring the utilization of value based insurance design to demonstrate that reducing the copayment or co-insurance charged to Medicare beneficiaries for selected high-value prescription medications and clinical services can increase their utilization and ultimately improve clinical outcomes and lower health care expenditures. HR 5380 - Medicare Telehealth Parity Act of 2014: To amend title XVIII of the Social Security Act to provide for a phased in expansion of telehealth coverage under Medicare program. S 1932 - Better Care and Lower Costs Act: 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, and for other purposes. S 2000 - The SGR Repeal and Medicare Provider Payment Modernization Act: Amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals and for other purposes. S 2552 - Medicare Advantage Participant Bill of Rights Act of 2014: To enhance beneficiary & provider protections and improve transparency in the Medicare Advantage market and for other purposes.

Client expense: $1,510,000 · Firm income: Not reported

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

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Health care coverage and payment options in tax reform discussions Policies affecting nurse practitioner education and workforce Definition of essential health benefits Health information technology and electronic health records Mental health services and violence prevention Draft legislation on reauthorization of the National Quality Forum Coverage and payment for health care services furnished to undocumented immigrant children H.R. 297/S. 1557 - Childrens Hospital GME Support Reauthorization Act H.R. 628/S. 195 - Mental Health in Schools Act H.R. 647 - Achieving a Better Life Experience (ABLE) Act H.R. 669 - Sudden Unexpected Death Data Enhancement and Awareness Act H.R. 1249/S. 1756 - Common Sense Nutrition Disclosure Act H.R. 1281/S. 1417 - Newborn Screening Saves Lives Reauthorization Act H.R. 1427 - Truth in Healthcare Marketing Act H.R. 1791 - Medical Preparedness Allowable Use Act H.R. 1947/H.R. 2642 - Federal Agriculture Reform and Risk Management (FARRM) Act H.R. 2019 - Gabriella Miller Kids First Research Act H.R. 2285 - Strategies to Address Antimicrobial Resistance Act H.R. 2575 - Save American Workers Act H.R. 2663/S. 1422 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 2833/S. 2278 - Safeguarding Care of Patients Everywhere (SCOPE) Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 3102 - Nutrition Reform and Work Opportunity Act H.R. 3121 - American Health Care Reform Act H.R. 3147 - Food Labeling Modernization Act H.R. 3306/S. 2662 - Telehealth Enhancement Act H.R. 3471/S. 1696 - Women's Health Protection Act H.R. 3527 - Poison Center Network Act H.R. 3717 - Helping Families in Mental Health Crisis Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment (ADAPT) Act H.R. 4118 - Suspending the Individual Mandate Penalty Law Equals (SIMPLE) Fairness Act H.R. 4290 - Wakefield Act H.R. 4574 - Strengthening Mental Health in Our Communities Act H.R. 4631/S. 2449 - Autism Collaboration, Accountability, Research, Education and Support (Autism CARES) Act H.R. 4673 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 4783 - Promoting Healthy Minds for Safer Communities Act H.R. 4888 - Coordinated Recovery Initiative for Babies (CRIB) Act H.R. 5279 - Sugar-Sweetened Beverages Tax (SWEET) Act S. 264/H.R. 1263 - Excellence in Mental Health Act S. 689 - Mental Health Awareness and Improvement Act S. 696 - Safe Chemicals Act S. 744/H.R. 15 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 954 - Agriculture Reform, Food, and Jobs Act S. 1009 - Chemical Safety Improvement Act S. 1014 - Youth Sports Concussion Act S. 1086 - Safe Child Care Act/Child Care and Development Block Grant Reauthorization Act S. 1152 - Building a Health Care Workforce for the Future Act S. 1417 - Newborn Screening Saves Lives Act S. 1697 - Strong Start for Americas Children Act S. 1758 - Quality Data, Quality Healthcare Act S. 1932/H.R. 3890 - Better Care, Lower Cost Act S. 2047 - Protecting Children from Electronic Cigarette Advertising Act S. 2154 - Emergency Medical Services for Children Reauthorization Act S. 2229 - Expanding Primary Care Access and Workforce Act S. 2434/H.R. 4865 - Family Coverage Act S. 2491 - Medicare Protection Act S. 2581 - Child Nicotine Poisoning Prevention Act S. 2728 - Community-Based Medical Education Act S. 2804 - Family Asthma Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), 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), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 3890/S. 1932 -- Better Care, Lower Cost Act Implementation issues related to the Pharmaceutical Quality, Security and Accountability Act (P.L. 113-54

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013; provisions related to the Independent Payment Advisory Board H.R. 928 - Medicare Prescription Drug Savings and Choice Act of 2013; provisions related to Medicare Part D H.R. 1024 - Medication Therapy Empowerment Act of 2013; provisions related to Part D issues H.R. 1102 - Medicare Prescription Drug Price Negotiation Act of 2013; Provisions related to Part D issues and non-interference H.R. 1588 - Medicare Drug Savings Act of 2013; provisions related to Part D issues H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013; Provisions related to SGR reform H.R. 2827 - To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D; provisions related to Medicare Part D Drug Tier Formularies H.R. 3890 - Better Care, Lower Cost Act; Provisions related to Part D, value-based insurance design, and chronic disease H.R 4160 - Keep the Promise to Seniors Act of 2014; provisions related to Part D H.R. 4187 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 4302 - Protecting Access to Medicare Act of 2014; provisions related to the biopharmaceutical industry S. 117 - Medicare Prescription Drug Price Negotiation Act of 2013; provisions related to Part D issues S. 351 - Protecting Seniors' Access to Medicare Act of 2013; provisions related to the Independent Payment Advisory Board S. 408 - Medicare Prescription Drug Savings and Choice Act of 2013; provisions related to Medicare Part D S. 557 - Medication Therapy Empowerment Act of 2013; provisions related to Part D issues S. 740 - Medicare Drug Savings Act of 2013; provisions related to Part D issues S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013; Provisions related to reforming Medicare physician payments S. 1932 - Better Care, Lower Cost Act; Provisions related to Part D, value-based insurance design, and chronic disease S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014; Provisions related to SGR reform S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; Provisions related to SGR reform No bill # assigned - Contract Year 2015 Policy and Technical Cganges to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs; Provisions related to Part D No bill # assigned - Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy No bill # assigned - Issues related to better use of medicines and comprehensive medication management No bill # assigned - Medicaid Program, Covered Outpatient Drugs rulemaking No bill # assigned - Implementation Issues relating to the Physician Payment Sunshine ActNo bill # assigned - Vaccine access and coverage issues

Client expense: $580,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)

S. 1064: Medicares Physician Definition, Amends title XVIII (Medicare) of the Social Security Act to treat as a physician, for Medicare purposes, a clinical psychologist acting within the scope of a psychologist's license (or other state law authorization), but only with respect to the furnishing of clinical psychologists services which the psychologist is legally authorized to perform by the state. H.R. 794: Medicares Physician Definition, to amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. S. 1184/H.R. 2415: Treat and Reduce Obesity Act of 2013. A bill to amend title XVIII of the Social Security Act to include information on the coverage of intensive behavioral therapy for obesity in the Medicare and You Handbook and to provide for the coordination of programs to prevent and treat obesity, and for other purposes. H.R. 2810: Medicare Patient Access and Quality Improvement Act of 2013. To amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians' services, and for other purposes. H.R. 2817: Protect Patient Access to Quality Health Professionals Act of 2013. To amend title XXVII of the Public Health Service Act to remove the non-discrimination requirements relating to health care providers. H.R. 4015, S. 2000: The SGR Repeal and Medicare Provider Payment Modernization Act of 2014. To amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians services, and for other purposes. H.R. 2110: Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 To amend titles XVIII and XIX of the Social Security Act to repeal the Medicare sustainable growth rate and to improve Medicare and Medicaid payments, and for other purposes. S. 1932: The Better Care, Lower Cost Act. To amend title XVIII of the Social Security Act to establish an integrated chronic care delivery programs.

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2000/ S. 2110/H.R. 4015/H.R. 4302: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.1769: Standard of Care Protection Act S. 2405/H.R. 4080: Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.1932: Better Care, Lower Cost Act S. 2800: Patient Centered Quality Care for Life Act S. 641: Palliative Care and Hospice Education and Training Act S. 2348: Removing Barriers to Colorectal Cancer Screening Act of 2014 H.R. 3230: Veterans Access, Choice, and Accountability Act of 2014 H.R. 4750: Standard of Care Protection Act of 2014 H.R. 4841/ S. 2450 Veterans' Access to Care through Choice, Accountability and Transparency Act of 2014 H.R. 4106: Saving Lives, Saving Costs Act H.R. 1427: Truth in Healthcare Marketing Act of 2013 H.R. 3991/S. 2037: Critical Access Hospital Relief Act of 2014 H.R. 2027: Expanding Patients' Access to Quality Care Act of 2013 H.R. 3796: Comprehensive Care Payment Innovation Act H.R. 36: Health Care Safety Net Enhancement Act of 2013 H.R. 1733/S. 2196: Good Samaritan Health Professionals Act H.R. 2810/S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 809: Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2013 H.R. 3548: Improving Trauma Care Act of 2013 H.R. 1827: Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 2500: Ambulatory Surgical Center Quality and Access Act of 2013 H.R. 3722/S. 2220: Sports liability legislation H.R. 4384: America HEALS Act H.R. 3547: Consolidated Appropriations Act, 2014 Two midnights policy Cancer funding IOASE (In Office Ancillary Services Exemption) ICD-10 NIH research funding appropriations request 21st Century Cures Initiative HIT/Big Data CHIP reauthorization Legal Liability Legislation National Trauma Institute Agenda 2015 Medicare Physician Fee Schedule Clinical Data Registries S-CAHPS Network adequacy Physician Tiering Device Tax Protecting Integrity in Medicare Act Misvalued Codes 10- and 90-Day Global Code Transition Pay-for-Performance Programs Hospital Improvements for Payment (HIP) Act of 2014 Medical Electronic Data Technology Enhancement for Consumers' Health (MEDTECH) Act

Client expense: $21,375 · Firm income: Not reported

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

S. 2000/ S. 2110/H.R. 4015/H.R. 4302: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.1769: Standard of Care Protection Act S. 2405/H.R. 4080: Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.1932: Better Care, Lower Cost Act S. 2800: Patient Centered Quality Care for Life Act S. 641: Palliative Care and Hospice Education and Training Act S. 2348: Removing Barriers to Colorectal Cancer Screening Act of 2014 H.R. 3230: Veterans Access, Choice, and Accountability Act of 2014 H.R. 4750: Standard of Care Protection Act of 2014 H.R. 4841/ S. 2450 Veterans' Access to Care through Choice, Accountability and Transparency Act of 2014 H.R. 4106: Saving Lives, Saving Costs Act H.R. 1427: Truth in Healthcare Marketing Act of 2013 H.R. 3991/S. 2037: Critical Access Hospital Relief Act of 2014 H.R. 2027: Expanding Patients' Access to Quality Care Act of 2013 H.R. 3796: Comprehensive Care Payment Innovation Act H.R. 36: Health Care Safety Net Enhancement Act of 2013 H.R. 1733/S. 2196: Good Samaritan Health Professionals Act H.R. 2810/S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 809: Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2013 H.R. 3548: Improving Trauma Care Act of 2013 H.R. 1827: Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 2500: Ambulatory Surgical Center Quality and Access Act of 2013 H.R. 3722/S. 2220: Sports liability legislation H.R. 4384: America HEALS Act H.R. 3547: Consolidated Appropriations Act, 2014 Two midnights policy Cancer funding IOASE (In Office Ancillary Services Exemption) ICD-10 NIH research funding appropriations request 21st Century Cures Initiative HIT/Big Data CHIP reauthorization Legal Liability Legislation National Trauma Institute Agenda 2015 Medicare Physician Fee Schedule Clinical Data Registries S-CAHPS Network adequacy Physician Tiering Device Tax Protecting Integrity in Medicare Act Misvalued Codes 10- and 90-Day Global Code Transition Pay-for-Performance Programs Hospital Improvements for Payment (HIP) Act of 2014 Medical Electronic Data Technology Enhancement for Consumers' Health (MEDTECH) Act

Client expense: $21,375 · Firm income: Not reported

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

S. 2000/ S. 2110/H.R. 4015/H.R. 4302: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.1769: Standard of Care Protection Act S. 2405/H.R. 4080: Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.1932: Better Care, Lower Cost Act S. 2800: Patient Centered Quality Care for Life Act S. 641: Palliative Care and Hospice Education and Training Act S. 2348: Removing Barriers to Colorectal Cancer Screening Act of 2014 H.R. 3230: Veterans Access, Choice, and Accountability Act of 2014 H.R. 4750: Standard of Care Protection Act of 2014 H.R. 4841/ S. 2450 Veterans' Access to Care through Choice, Accountability and Transparency Act of 2014 H.R. 4106: Saving Lives, Saving Costs Act H.R. 1427: Truth in Healthcare Marketing Act of 2013 H.R. 3991/S. 2037: Critical Access Hospital Relief Act of 2014 H.R. 2027: Expanding Patients' Access to Quality Care Act of 2013 H.R. 3796: Comprehensive Care Payment Innovation Act H.R. 36: Health Care Safety Net Enhancement Act of 2013 H.R. 1733/S. 2196: Good Samaritan Health Professionals Act H.R. 2810/S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 809: Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2013 H.R. 3548: Improving Trauma Care Act of 2013 H.R. 1827: Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 2500: Ambulatory Surgical Center Quality and Access Act of 2013 H.R. 3722/S. 2220: Sports liability legislation H.R. 4384: America HEALS Act H.R. 3547: Consolidated Appropriations Act, 2014 Two midnights policy Cancer funding IOASE (In Office Ancillary Services Exemption) ICD-10 NIH research funding appropriations request 21st Century Cures Initiative HIT/Big Data CHIP reauthorization Legal Liability Legislation National Trauma Institute Agenda 2015 Medicare Physician Fee Schedule Clinical Data Registries S-CAHPS Network adequacy Physician Tiering Device Tax Protecting Integrity in Medicare Act Misvalued Codes 10- and 90-Day Global Code Transition Pay-for-Performance Programs Hospital Improvements for Payment (HIP) Act of 2014 Medical Electronic Data Technology Enhancement for Consumers' Health (MEDTECH) Act

Client expense: $54,750 · Firm income: Not reported

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

S. 2000/ S. 2110/H.R. 4015/H.R. 4302: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.1769: Standard of Care Protection Act S. 2405/H.R. 4080: Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.1932: Better Care, Lower Cost Act S. 2800: Patient Centered Quality Care for Life Act S. 641: Palliative Care and Hospice Education and Training Act S. 2348: Removing Barriers to Colorectal Cancer Screening Act of 2014 H.R. 3230: Veterans Access, Choice, and Accountability Act of 2014 H.R. 4750: Standard of Care Protection Act of 2014 H.R. 4841/ S. 2450 Veterans' Access to Care through Choice, Accountability and Transparency Act of 2014 H.R. 4106: Saving Lives, Saving Costs Act H.R. 1427: Truth in Healthcare Marketing Act of 2013 H.R. 3991/S. 2037: Critical Access Hospital Relief Act of 2014 H.R. 2027: Expanding Patients' Access to Quality Care Act of 2013 H.R. 3796: Comprehensive Care Payment Innovation Act H.R. 36: Health Care Safety Net Enhancement Act of 2013 H.R. 1733/S. 2196: Good Samaritan Health Professionals Act H.R. 2810/S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 809: Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2013 H.R. 3548: Improving Trauma Care Act of 2013 H.R. 1827: Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 2500: Ambulatory Surgical Center Quality and Access Act of 2013 H.R. 3722/S. 2220: Sports liability legislation H.R. 4384: America HEALS Act H.R. 3547: Consolidated Appropriations Act, 2014 Two midnights policy Cancer funding IOASE (In Office Ancillary Services Exemption) ICD-10 NIH research funding appropriations request 21st Century Cures Initiative HIT/Big Data CHIP reauthorization Legal Liability Legislation National Trauma Institute Agenda 2015 Medicare Physician Fee Schedule Clinical Data Registries S-CAHPS Network adequacy Physician Tiering Device Tax Protecting Integrity in Medicare Act Misvalued Codes 10- and 90-Day Global Code Transition Pay-for-Performance Programs Hospital Improvements for Payment (HIP) Act of 2014 Medical Electronic Data Technology Enhancement for Consumers' Health (MEDTECH) Act

Client expense: $54,750 · Firm income: Not reported

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

H.R.3890/S.1932, Better Care, Lower Cost Act. Implementation issues related to the Pharmaceutical Quality, Security, and Accountability Act (P.L. 113-54). Regulatory and legislative health care issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Education and importance of various pharmaceutical industry issues, including the Part D prescription drug program; and broad payment reform issues included within P.L. 113-93, Protecting Access to Medicare Act of 2014; and S.1932, Better Care, Lower Cost Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1932/H.R. 3890 - Better Care, Lower Cost Act; H.R. 1179 - Improving Access to Medicare Coverage Act; H.R. 5373 - Put a Registered Nurse in the Nursing Home Act; H.R.2504/S. 1332 - Home Health Care Access Improvement Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1932/H.R. 3890 - Better Care, Lower Cost Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Medicare medicaid legislationH.R. 351 - Protecting Seniors' Access to Medicare Act of 2013; provisions related to the Independent Payment Advisory Board H.R. 928 - Medicare Prescription Drug Savings and Choice Act of 2013; provisions related to Medicare Part D H.R. 1024 - Medication Therapy Empowerment Act of 2013; provisions related to Part D issues H.R. 1102 - Medicare Prescription Drug Price Negotiation Act of 2013; Provisions related to Part D issues and non-interference H.R. 1588 - Medicare Drug Savings Act of 2013; provisions related to Part D issues H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013; Provisions related to SGR reform H.R. 2827 - To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D; provisions related to Medicare Part D Drug Tier Formularies H.R. 3890 - Better Care, Lower Cost Act; Provisions related to Part D, value-based insurance design, and chronic disease H.R 4160 - Keep the Promise to Seniors Act of 2014; provisions related to Part D H.R. 4187 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 4302 - Protecting Access to Medicare Act of 2014 - provisions related to the biopharmaceutical industry S. 117 - Medicare Prescription Drug Price Negotiation Act of 2013; provisions related to Part D issues S. 351 - Protecting Seniors' Access to Medicare Act of 2013; provisions related to the Independent Payment Advisory Board S. 408 - Medicare Prescription Drug Savings and Choice Act of 2013; provisions related to Medicare Part D S. 557 - Medication Therapy Empowerment Act of 2013; provisions related to Part D issues S. 740 - Medicare Drug Savings Act of 2013; provisions related to Part D issues S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013; Provisions related to reforming Medicare physician payments S. 1932 - Better Care, Lower Cost Act; Provisions related to Part D, value-based insurance design, and chronic disease S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014; Provisions related to SGR reform S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; Provisions related to SGR reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General briefings to government officials on the status of Molycorp's vertically integrated rare earth manufacturing supply chain; production the Mountain Pass Rare Earth Facility; technology trends related to rare earth permanent magnetic materials; and the potential for rare earth materials to be used in clean energy, advanced transportation, energy efficiency, and other technologies. -- H.R. 4435, National Defense Authorization Act for Fiscal Year 2014, issues related to strategic materials such as rare earth elements -- S. 1932, Energy Savings and Industrial Competitiveness Act of 2014, issues related to strategic materials and advanced, high-efficiency motors that utilize rare earth elements -- S. 2002, Motor Systems Market Awareness Act of 2014, issues related to high-efficiency motors that utilize rare earth elements -- S. 2006, National Rare Earth Cooperative Act of 2014, issues related to rare earth resources and production technologies -- S.1600, Critical Minerals Policy Act of 2013, issues related to rare earth resources and production technologies

Client expense: $84,000 · Firm income: Not reported

Government targets: Central Intelligence Agency (CIA), Commerce, Dept of (DOC), Defense Intelligence Agency (DIA), Defense Logistics Agency, Defense, Dept of (DOD), Energy, Dept of, HOUSE OF REPRESENTATIVES, SENATE, White House Office

General briefings to government officials on the status of Molycorp's vertically integrated rare earth manufacturing supply chain; production increases the Mountain Pass Rare Earth Facility; technology trends related to rare earth permanent magnetic materials; and the potential for rare earth materials to be used in clean energy, advanced transportation, energy efficiency, and other technologies. -- H.R. 4435, National Defense Authorization Act for Fiscal Year 2014, issues related to strategic materials such as rare earth elements -- S. 1932, Energy Savings and Industrial Competitiveness Act of 2014, issues related to strategic materials and advanced, high-efficiency motors that utilize rare earth elements -- S. 2006, National Rare Earth Cooperative Act of 2014, issues related to rare earth resources and production technologies -- S.1600, Critical Minerals Policy Act of 2013, issues related to rare earth resources and production technologies Printed

Client expense: $84,000 · Firm income: Not reported

Government targets: Central Intelligence Agency (CIA), Commerce, Dept of (DOC), Defense Intelligence Agency (DIA), Defense Logistics Agency, Defense, Dept of (DOD), Energy, Dept of, HOUSE OF REPRESENTATIVES, SENATE, White House Office

General briefings to government officials on the status of Molycorp's vertically integrated rare earth manufacturing supply chain; production increases the Mountain Pass Rare Earth Facility; technology trends related to rare earth permanent magnetic materials; and the potential for rare earth materials to be used in clean energy, advanced transportation, energy efficiency, and other technologies. -- S. 1932, Energy Savings and Industrial Competitiveness Act of 2014, issues related to strategic materials and advanced, high-efficiency motors that utilize rare earth elements -- S. 2002, Motor Systems Market Awareness Act of 2014, issues related to high-efficiency motors that utilize rare earth elements -- S.1600, Critical Minerals Policy Act of 2013, issues related to rare earth resources and production technologies

Client expense: $84,000 · Firm income: Not reported

Government targets: Central Intelligence Agency (CIA), Commerce, Dept of (DOC), Defense Intelligence Agency (DIA), Defense Logistics Agency, Defense, Dept of (DOD), Energy, Dept of, HOUSE OF REPRESENTATIVES, SENATE, White House Office

Better Care, Lower Cost Act (Wyden) (S.1932) Medication Adherence Medicare 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)

Client expense: $19,160 · 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), 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

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 S 1143 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.

Client expense: $4,270,000 · Firm income: Not reported

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

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Health care coverage and payment options in tax reform discussions Policies affecting nurse practitioner education and workforce Definition of essential health benefits Health information technology and electronic health records Mental health services and violence prevention Draft legislation on reauthorization of the National Quality Forum Coverage and payment for health care services furnished to undocumented immigrant children H.R. 297/S. 1557 - Childrens Hospital GME Support Reauthorization Act H.R. 628/S. 195 - Mental Health in Schools Act H.R. 669 - Sudden Unexpected Death Data Enhancement and Awareness Act H.R. 1249/S. 1756 - Common Sense Nutrition Disclosure Act H.R. 1281/S. 1417 - Newborn Screening Saves Lives Reauthorization Act H.R. 1427 - Truth in Healthcare Marketing Act H.R. 1791 - Medical Preparedness Allowable Use Act H.R. 1947/H.R. 2642 - Federal Agriculture Reform and Risk Management (FARRM) Act H.R. 2019 - Gabriella Miller Kids First Research Act H.R. 2285 - Strategies to Address Antimicrobial Resistance Act H.R. 2575 - Save American Workers Act H.R. 2663/S. 1422 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 2833/S. 2278 - Safeguarding Care of Patients Everywhere (SCOPE) Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 3102 - Nutrition Reform and Work Opportunity Act H.R. 3121 - American Health Care Reform Act H.R. 3147 - Food Labeling Modernization Act H.R. 3306/S. 2662 - Telehealth Enhancement Act H.R. 3471/S. 1696 - Women's Health Protection Act H.R. 3527 - Poison Center Network Act H.R. 3717 - Helping Families in Mental Health Crisis Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment (ADAPT) Act H.R. 4118 - Suspending the Individual Mandate Penalty Law Equals (SIMPLE) Fairness Act H.R. 4290 - Wakefield Act H.R. 4574 - Strengthening Mental Health in Our Communities Act H.R. 4631/S. 2449 - Autism Collaboration, Accountability, Research, Education and Support (Autism CARES) Act H.R. 4673 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 4783 - Promoting Healthy Minds for Safer Communities Act H.R. 4888 - Coordinated Recovery Initiative for Babies (CRIB) Act H.R. 5279 - Sugar-Sweetened Beverages Tax (SWEET) Act S. 264/H.R. 1263 - Excellence in Mental Health Act S. 689 - Mental Health Awareness and Improvement Act S. 696 - Safe Chemicals Act S. 744/H.R. 15 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 954 - Agriculture Reform, Food, and Jobs Act S. 1009 - Chemical Safety Improvement Act S. 1014 - Youth Sports Concussion Act S. 1086 - Safe Child Care Act/Child Care and Development Block Grant Reauthorization Act S. 1152 - Building a Health Care Workforce for the Future Act S. 1417 - Newborn Screening Saves Lives Act S. 1697 - Strong Start for Americas Children Act S. 1758 - Quality Data, Quality Healthcare Act S. 1932/H.R. 3890 - Better Care, Lower Cost Act S. 2047 - Protecting Children from Electronic Cigarette Advertising Act S. 2154 - Emergency Medical Services for Children Reauthorization Act S. 2229 - Expanding Primary Care Access and Workforce Act S. 2434/H.R. 4865 - Family Coverage Act S. 2491 - Medicare Protection Act S. 2581 - Child Nicotine Poisoning Prevention Act S. 2728 - Community-Based Medical Education Act S. 2804 - Family Asthma Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), 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), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 2375 -Transparency and Accountability in Medicare Bidding Act of 2013 - provisions related to Round One recompete and implications for diabetes products. HR 2810 - The Medicare Patient Access and Quality Improvement Act of 2013 - issues related to reform of the physician fee schedule and the SGR formula.H.R. 2725 - FDA Safety Over Sequestration Act of 2013, and S. 1413 FDA User Fee Protection Act - provisions related to protecting industry paid user fees from sequestration H.R. 2663 & S. 1422 - The Preventative Health Savings Act - provisions that will permit leaders in Congress to request that CBO estimate the long-term health savings that are possible from preventative health initiatives like abdominal aortic aneurysm, hypertension screenings. H.R. 3077 The TELE-MED Act of 2013 provisions related to telemedicine and remote monitoring that increase access to health care and enhance patient outcomes H.R. 3303 Software Act of 2013 - provisions related to FDA regulation of health information technology and mobile medical applications S. 1932 - Better Care, Lower Cost Act - provisions related to management of chronic disease H.R. - 3890 - Better Care, Lower Cost Act - provisions related to management of chronic disease Issues related to neuroscience research Issues related to the discovery, development and delivery of promising new treatments to patients (21st Century Cures).

Client expense: $1,420,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions and prescription drug abuse. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 7.Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8.Healthier Lifestyles and Prevention America Act (S. 39) 9.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392/H.R. 2160) 10.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 11.Personal Health Investment Today Act (H.R. 956) 12.A bill to provide for a sequester replacement (S. 16/S. 799) 13.American Family Economic Protection Act of 2013 (S. 388) 14.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933/Public Law 113-6) 15.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 16.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 17.Physical Activity Guidelines for Americans Act (S. 531/H.R. 2179) 18.Firearm Safety and Public Health Research Act (H.R. 321) 19.Energy Consumers Relief Act (S. 1363/H.R. 1582) 20.Common Sense Nutrition Disclosure Act (H.R. 1249/S. 1756) 21.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 22.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 23.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 24.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 25.FIT Kids Act (S. 1033/H.R. 2178) 26.Strengthening Americas Schools Act (S. 1094) 27.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 28.Fit to Serve Act (S. 976) 29.Climate Change Health Protection and Promotion Act (H.R. 2023/S. 2864) 30.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 31.Student Success Act (H.R. 5) 32.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 33.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 34.Senate FY14 Labor, Health and Human Services, and Education Bill (S. 1284) 35.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 36.Pharmacy Compounding Quality and Accountability Act (S. 959) 37.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 38.Implementation of Drug Supply Chain Security Act (P.L. 113-54) 39.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 40.Healthy Families Act (H.R. 1286/S. 631) 41.FY2014 Continuing Resolution (H.J. Res. 59) 42.Pharmaceutical Quality, Security and Accountability Act (S. 959) 43.Energy Consumers Relief Act (S. 1363/H.R. 1582) 44.Increasing the Safety of Prescription Drug Use Act (S. 1657) 45.National Energy Tax Repeal Act (S. 1324) 46.Saving Coal Jobs Act of 2013 (S. 1514/H.R. 5077) 47.Community Parks Revitalization Act (H.R. 2424) 48.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 49.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 50.Nutrition Reform and Work Opportunity Act (H.R. 3102) 51.Health Equity and Accountability Act (H.R. 5294) 52.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 53.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 54.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 55.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 56.The Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102, Public Law 113-79) 57.Better Care, Lower Cost Act (S. 1932/H.R. 3890) 58.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 59.The Consolidated Appropriations Act of 2014 (H.R. 3547/Public Law 113-76 60.Strategies to Address Antimicrobial Resistance (STAAR) Act (S. 2236/H.R. 2285) 61.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 62.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 63.Electricity Security and Affordability Act (S. 1905/H.R. 3826) 64.Stop Overdose Stat Act (HR 4169) 65.Overdose Prevention Act (S 2755) 66.Opioid Overdose Reduction Act (S. 2092/H.R. 4288) 67.Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2014 (DISARM Act) (H.R. 4187) 68.Child Care and Development Block Grant Act of 2014 (S. 1086) 69.Departments of Labor, Health and Human Services and Education And Related Agencies Fiscal Year 2015 Appropriations Bill (including H.R. 5464) 70.Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2015 (S. 2389 / H.R. 4800) 71.Department of the Interior, Environment, and Related Agencies appropriations legislation, 2015 (including H.R. 5171) 72.MAP-21 Reauthorization Act (S. 2322) 73.Stop Subsidizing Childhood Obesity Act (S. 2342/H.R. 2831) 74.ENRICH Act (H.R. 4427) 75.Healthy Kids Outdoors Act of 2014 (S. 2367/H.R. 4706) 76.Summer Meals Act of 2014 (S. 2527/HR. 5012) 77.Long-Term SCORE Act (H.R. 4444) 78.American Cures Act (S. 2115/H.R. 4384) 79.A joint resolution to disapprove a rule of the Environmental Protection Agency relating to greenhouse gas emissions from electric utility generating units. (S.J. Res 30) 80.Fit for Life Act of 2014 (H.R.4765) 81.School Food Modernization Act (S. 2210/H.R. 1783) 82.Protecting Children from Electronic Cigarette Advertising Act of 2014 (S. 2014/H.R. 4325) 83.Pedestrian Safety Act of 2014 (S. 2284) 84.Safe Streets Act of 2014 (S. 2004/H.R. 2468) 85.The Recovery Enhancement for Addiction Treatment Act (S. 2645) 86.FY 2015 Financial Services and General Government Appropriations bill, in support of an appropriation for the National Alliance for Model State Drug Laws (including H.R. 5016) 87.Vector-Borne Disease Research Accountability and Transparency Act (H.R. 4701) 88.Highway and Transportation Funding Act of 2014 (H.R. 5021/Public Law 113-520) 89.Full-Service Community Schools Act of 2014 (H.R. 5168) 90.PREPARE Act of 2014 (H.R. 5314) 91.Waters of the United States Regulatory Overreach Protection Act of 2014 (S. 2496/H.R. 5078) 92.American Energy Solutions for Lower Costs and More American Jobs Act (H.R.

Client expense: $38,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

(1) Issues related to Public Law 111-148 - The Patient Protection and Affordable Care Act (provisions related to Medicaid and Medicare); (2) Issues related to Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 (provisions related to Medicaid and Medicare); (3) Issues pertaining to entitlement reform, Medicare Advantage, Medicaid Dual Eligibles, and Medicare reimbursement and enrollment; (4) Issues related to S. 1932 - Better Care, Lower Cost Act; (5) Issues related to H.R. 4302 -Protecting Access to Medicare Act, and Rate Notice; and (6) Issues related to S. 1871 - The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013; and (7) Issues related to S. 2461 CHIP Extension Act of 2014.

Client expense: $430,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2753 Securing Care for Seniors Act: Provisions related to Value Based Insurance Design H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to fraud and abuse H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 3890 Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to sustainable growth rate (SGR) and Medicare provider payment reform H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014: Provisions related to Part D preferred pharmacy networks H.R. 5183, Value Based Insurance Design for Better Care Act of 2014: Provisions related to valued base insurance design demonstration program H.R. 5558 ACO Improvement Act: Provisions related to alternate payment models S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 557, Medication Therapy Management Empowerment Act of 2013: Provisions related to Part D and medication therapy management S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence Protecting Integrity in Medicare Act of 2014 (no bill number): Provisions related to addressing fraud, prescription drug abuse, and other issues Lock-in concepts generally

Client expense: $3,680,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Patent & Trademark Office (PTO), SENATE, U.S. Trade Representative (USTR)

S. 452/H.R. 962, the Medicare Diabetes Prevention Act. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. H.R. 2663/S. 1422, the Preventive Health Savings Act. H.R. 3322, the Eliminating Disparities in Diabetes Prevention, Access and Care Act. S. 1932, the Better Care, Lower Cost Act. H.R. 5294, the Health Equity and Accountability Act. S. 2210/H.R. 1783, the School Food Modernization Act.S. 452/H.R. 962, the Medicare Diabetes Prevention Act. Support entire bill; provides for Medicare coverage of National Diabetes Prevention Program. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. Support entire bill; provides funding for the establishment of a tracking and surveillance system at the CDC and provides grant funding for public health research on gestational diabetes. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. Support entire bill; requires states to report on and reach physical education benchmarks; and requires training of physical education teachers and school administrators; physical education curriculum; and dedicated school space for physical education and physical activity. H.R. 2663/S. 1422, the Preventive Health Savings Act. Support entire bill; requires the Director of the Congressional Budget Office, upon a request by the chairman or ranking minority member of certain congressional committees, to determine if proposed legislation would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services. H.R. 3322, the Eliminating Disparities in Diabetes Prevention, Access and Care Act. Support entire bill; expands resources at NIH, CDC, the Health Resources and Services Administration, and the Indian Health Service to promote research, treatment and education regarding diabetes in minority populations. S. 1932, the Better Care, Lower Cost Act. Support part of bill; establishes a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions, and for other purposes. H.R. 5294, the Health Equity and Accountability Act. Support provisions addressing diabetes, including the Eliminating Disparities in Diabetes Prevention, Access and Care Act (sections 771-775) and the Gestational Diabetes Act (section 509). S. 2210/H.R. 1783, the School Food Modernization Act. Support entire bill; provides loans to schools to update kitchen equipment in order to prepare healthy foods for students. Issues worked on the Hill not yet reflected in legislation: Special Diabetes Program. The Special Diabetes Program consists of two mandatory funding streams Special Diabetes Program for type 1 and Special Diabetes Program for Indians. The funding is set to expire September 30, 2015 unless Congress acts to reauthorize the program. United States Preventive Services Task Force (USPSTF). Support any efforts to require the USPSTF to update its recommendation for diabetes screening, including gestational diabetes screening, based on new evidence. The Physician Payments Sunshine Act (also called the Open Payments Program) of the Affordable Care Act. Requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The Association would like to see the Centers for Medicare and Medicaid Services make an Open Payments Program reporting exemption for indirect payments made to voluntary health agencies (VHAs) in cases when an applicable manufacturer grants full and independent discretion to VHAs in selecting recipients for funding.

Client expense: $123,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE