Two-Midnight Rule Coordination and Improvement Act of 2014

Save Rural Hospitals Act (H.R.3225) Funding for 340B Drug Pricing Program Critical Access Hospital Relief Act (S. 258; H.R. 169) Support for Medicare and Medicaid Payment reductions, including Graduate Medical Education Support for Resident Physician Shortage Act of 2015 (S. 1148; H.R. 2124) Opposing Medicare and Medicaid Payment reductions, including those to Graduate Medical Education (H.R. 3292, the Medicare IME Pool Act of 2015), bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) payments, CAH payments, IPPS coding offset, rural hospital payments, hospital outpatient department (HOPD) clinics, and sequestration. Support for changes to site-neutral payment provision of Bipartisan Budget Act of 2015 (P.L. 114-74) and flexibility in implementation of Section 603 of the law. Protecting 340B Drug Pricing Program in regulatory and legislative proposals Support for Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) and inclusion of similar provision in Helping Hospitals Improve Patient Care Act (H.R. 5273) Support for Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act (H.R. 2745) Addressing concerns related to the Physician Quality Reporting System (PQRS) and reporting mechanisms Encouraging Committees of jurisdiction to examine overlap in Merit-based Incentive Payment System and Medicare and Medicaid Electronic Health Record Incentive Payment Programs (Meaningful Use) Urging further flexibility in proposed rule [CMS-5517-P] to implement Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Opposition to redistribution of Medicare DSH payments proposed in FFY 2017 Inpatient Prospective Payment System (IPPS) rule [CMS-1655-P] Support for Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Support for Medicare Audit Improvement Act of 2015 (H.R. 2156) Support for Two-Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082)

Client expense: Not reported · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Opposing Medicare and Medicaid Payment reductions, including those to Graduate Medical Education (H.R. 3292, the Medicare IME Pool Act of 2015), bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) payments, CAH payments, IPPS coding offset, rural hospital payments, hospital outpatient department (HOPD) clinics, and sequestration. Support for changes to site-neutral payment provision of Bipartisan Budget Act of 2015 (P.L. 114-74) Protecting 340B Drug Pricing Program in regulatory and legislative proposals Support for changes to liver transplant allocation system 21st Century Cures Act (H.R. 6) and Senate HELP Committee provisions related to interoperability and information blocking Urging release of funding for Ebola preparedness and treatment Urging modifications to Hospital Compare Star Rating System Support for National Institutes of Health funding Support for Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act (H.R. 2745) Addressing concerns related to the Physician Quality Reporting System (PQRS) and reporting mechanisms Encouraging Committees of jurisdiction to examine overlap in Merit-based Incentive Payment System and Medicare and Medicaid Electronic Health Record Incentive Payment Programs (Meaningful Use) Support for Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Support for Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Support for Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Support for Protecting Access to Rural Therapies Act (H.R. 1611/S. 257) Support for Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Support for Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/ S. 1148) Support for Medicare Audit Improvement Act of 2015 (H.R. 2156) Support for Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Support for Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Support for Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227)

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

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

Opposing Medicare and Medicaid Payment reductions, including those to Graduate Medical Education (H.R. 3292, the Medicare IME Pool Act of 2015), bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) payments, CAH payments, IPPS coding offset, rural hospital payments, hospital outpatient department (HOPD) clinics, and sequestration. Support for changes to site-neutral payment provision of Bipartisan Budget Act of 2015 (P.L. 114-74) Protecting 340B Drug Pricing Program in regulatory and legislative proposals Support for finalizing Medicare and Medicaid Electronic Health Record Incentive Payment Programs (Meaningful Use) 2015-2017 Modifications Rule; support for delaying of Stage 3 Rule Urging Release of New York State Medicaid Vital Access Provider Program Funding Support for changes to liver transplant allocation system 21st Century Cures Act (H.R. 6) and Senate HELP Committee provisions related to interoperability and information blocking Urging release of funding for Ebola preparedness and treatment Support for National Institutes of Health funding Support for Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Support for Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Support for Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Support for Protecting Access to Rural Therapies Act (H.R. 1611/S. 257) Support for Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Support for Flexibility in Health IT Reporting Act of 2015 (H.R. 270) Support for Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/ S. 1148) Support for Medicare Audit Improvement Act of 2015 (H.R. 2156) Support for Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Support for Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Support for Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227)

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

21st Century Cures Act (H.R. 6) and Senate HELP Committee provisions related to interoperability and information blocking Urging release of funding for Ebola preparedness and treatment Support for Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Support for Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Support for Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Support for Protecting Access to Rural Therapies Act (H.R. 1611/S. 257) Support for Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Support for Flexibility in Health IT Reporting Act of 2015 (H.R. 270) Support for Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/ S. 1148) Support for Medicare Audit Improvement Act of 2015 (H.R. 2156) Support for Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Support for Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Support for Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Protecting 340B Drug Pricing Program in regulatory and legislative proposals Opposing Medicare and Medicaid Payment reductions, including those to Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) payments, CAH payments, IPPS coding offset, rural hospital payments, hospital outpatient department (HOPD) clinics, and sequestration. Support for finalizing Medicare and Medicaid Electronic Health Record Incentive Payment Programs (Meaningful Use) 2015-2017 Modifications Rule; support for delaying of Stage 3 Rule Urging Release of New York State Medicaid Vital Access Provider Program Funding Support for changes to liver transplant allocation system

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) 21st Century Cures Act (H.R. 6) Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Protecting Access to Rural Therapies Act (H.R. 1611/S. 257) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Flexibility in Health IT Reporting Act of 2015 (H.R. 270) Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/ S. 1148) Medicare Audit Improvement Act of 2015 (H.R. 2156) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Medicare and Medicaid Recovery Audit Contractor (RAC) Programs 340B Drug Pricing Program Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, hospital outpatient department (HOPD) clinics, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Liver transplant allocation system FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

Client expense: $240,000 · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Inpatient and outpatient hospital payments Issues and Legislation related to the Medicare Sustainable Growth Rate H.R.3698, Two-Midnight Rule Delay Act of 2013 S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 Issues Related to 340B Program Changes Issues Related to Telehealth

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

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

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

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

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

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

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support. General discussions of graduate medical education.

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support. General discussions about graduate medical education.

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support. General discussions of graduate medical education.

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

H.R. 1180, S. 577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

H.R. 4302, Protecting Access to Medicare Act of 2014: Medicare reimbursement pertaining to Medicare Sustainable Growth Rate Formula (SGR). S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2013; H.R. 3698, Two-Midnight Rule Delay Act of 2013: executive action pertaining to two-midnight rule issue; H.R. 1180, S. 577, Resident Physician Shortage Reduction Act of 2013, entire bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. CMMI Demonstration Program. Medicare Advantage in general. S. 1405, Medicare Ambulance Access Act of 2013. Medicare reimbursements, including reforms on sustainable growth rate. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014. H.R. 4302, Protecting Access to Medicare Act of 2014. H.R. 4930, ACE Kids Act of 2014.S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014. Medicare Part D payment and hospice. H.R. 5460 Medicare Ambulance Access, Fraud Prevention and Reform Act.

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

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

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. CMMI Demonstration Program. Medicare Advantage in general. S. 1405, Medicare Ambulance Access Act of 2013. Medicare reimbursements, including reforms on sustainable growth rate. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014. H.R. 4302, Protecting Access to Medicare Act of 2014. H.R. 4930, ACE Kids Act of 2014.S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014. Medicare Part D payment and hospice. H.R. 5460, Medicare Ambulance Access, Fraud Prevention and Reform Act.

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE

H.R. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 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. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 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 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 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: $30,000

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. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 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. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 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 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 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: $30,000

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. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 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. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 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 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 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: $30,000

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. 83: Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Medicare Audit Improvement Act of 2013 (H.R. 1250) Resident Physician Shortage Reduction Act (S. 577/H.R. 1180) Protecting Seniors Access to Medicare Act of 2013 (H.R. 351 and S. 351) The DSH Reduction Relief Act of 2013 (H.R. 1920) Rural Hospital Access Act (H.R. 1787) Rural Hospital Fairness Act (H.R. 2578) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188)/ Hospital Readmissions Program Accuracy and Accountability Act of 2014 (S. 2501) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Flexibility in Health IT Reporting Act (HR 5481) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Severe sepsis protocols Medicare and Medicaid Recovery Audit Contractor (RAC) Programs Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, inpatient coding offset, hospital outpatient department (HOPD) evaluation and management (E/M) services, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Hospital and health system pricing transparency Clinical quality measures and electronic clinical quality measures FY 2014 Inpatient Prospective Payment System Final Rule (CMS-1599-F) - Two-Midnight Policy FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

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

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

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

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

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

H.R.5464 and draft Senate legislation, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division G, Title II Issues: Support funding for NIH, Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Children's Hospitals Graduate Medical Education program (CHGME), HRSA, biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Support emergency supplemental funding to prepare and respond to Ebola and to reimburse for Ebola Virus Disease treatment. H.R. 4486 and draft Senate legislation, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division I, Title II President's Budget, FY 2016 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Funding for Community Health Centers and the NHSC. Debt in Health Education Loan programs (DebtHELP) bill (draft) Issues: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction Act of 2013 Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. H.R. 487, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act, Sections 5503 and 5506 Issue: Redistribution of residency positions. Issue: Implementation of and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the Affordable Care Act. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform. Issue: Support the use of animals in medical research. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Implementation of Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose discretionary spending cuts through sequestration, including NIH, Titles VII and VIII health professions and nursing education programs, and other science programs. Issue: Support primary care workforce development S. 1759, Teaching Health Center Reauthorization Act Issue: Legislation to reauthorize the Teaching Health Center Program and payments. Issue: Draft legislation on pain education in undergraduate and graduate medical education. H.R.548/S. 1152, The Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 5294, Health Equity and Accountability Act of 2014 Issue: Support bill to improve health equity. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. H.R. 3698, Two Midnight Rule Delay Act of 2013 S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act. S. 2501, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. Issue: Educating health professionals regarding prescription drug abuse and appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Support ACA consumer outreach and enrollment efforts. Issue: Implementation of the 340B drug discount program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Support preservation of funding for the Primary Care Residency Expansion program. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 5411, Trafficking Awareness Training for Health Care Act of 2014 Issue: Medical education curricula content pertaining to human trafficking. S. 2658/H.R.5580, Accelerating Biomedical Research Act Issue: To increase discretionary spending cap to increase funding for the National Institutes of Health (NIH). S. 2450, Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 4810, Veteran Access to Care Act Issue: Addressing VA backlogs by increasing care for veterans provided by non-VA facilities. S. 2115, American Cures Act H.R. 4384, America HEALS ACT Issue: Support establishment of a fund to provide an expanded and sustained investment in biomedical research. H.R. 4879, Research for All Act Issues: Support inclusion of male and female cells, tissues and animals in basic biomedical research. Support update of NIH guidelines to increase participation of women in clinical trials. Issue: FDA regulation of Laboratory Developed Tests (LDTs) S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 2645, The Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids S. 2942, The Infectious Disease Hospitals Hubs Act Issue: Support legislation to establish a network of hospitals in preparing for and responding to infectious diseases. Issue: Support nomination of Dr. Vivek Murthy as U.S. Surgeon General Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: U.S. Census Bureau on the American Community Survey CMS on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program CMS on final rule regarding definition of uninsured for purposes of Medicaid DSH limits HHS on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.) FDA on strategies for increasing patient involvement in regulatory processes. White House Ebola Response Coordinator offering to work with federal and state officials to prepare and respond to Ebola cases. NIH in response to an RFI related to the development of grant program to help facilitate the transition from training to independence. NIH on the consideration of sex as a biological variable in biomedical research The Patient-Centered Outcomes Research Institute (PCORI) on the proposed process for peer review and public release of its primary research finding. DEA on delaying the Disposal of Controlled Substances Final Rule.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction of 2013. Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparency. Issue: Implementation and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Support Medicare physician payment reform. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. H.R. 487, Primary Care Workforce Access Improvement Act. Issue: Residency training in community-based settings. Issue: Primary Care Workforce Development. President's Budget, FY 2015 Issue: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 H.R. 3698, Two Midnight Rule Delay Act of 2013 Issue: Support delay of Enforcement of new Centers for Medicare and Medicaid Services inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act S. 2501, Hospital Readmission Accuracy and Accountability Act Issue: Support inclusion of socioeconomic status as part of hospital readmissions program. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Issues: Support repeal of Medicares Sustainable Growth Rate (SGR) formula; Medicare physician payment reform. Issue: Draft legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Issue: Implementation of the 340B drug discount program. H.R. 4302, Protecting Access to Medicare Act of 2013. Issues: Support Medicare physician payment relief and extended delay of Medicare's "two-midnights" policy for hospital admissions; support the addition of GME language related to establishing Medicare caps and PRA; support delayed implementation of Medicaid DSH cuts. H.R. 4282, Creating Access to Residency Education Act of 2014 Issue: Create CMS grant program for new residency programs. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program including support for adoption of National Quality Forum (NQF) recommendations. Issue: Support Medicaid expansion advocacy efforts. Issue: Draft legislation on pain education in undergraduate and graduate medical education. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 4942, Underserved Veterans Access to Health Care Act Issue: Increasing funding for VA GME and Medicare GME. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014. Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the ACA. Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: Centers for Medicare & Medicaid Services (CMS) on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program. Centers for Medicare & Medicaid Services (CMS) on final rule regarding definition of uninsured for purposes of Medicaid DSH limits The Department of Health and Human Services (HHS) on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.)

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

H.R. 4302 - Protecting Access to Medicare Act of 2014. H.R. 3698 - Two-Midnight Rule Delay Act of 2013. S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L.112-25, The Budget Control Act (Sections regarding the impact of Medicare sequestration on hospitals) H.R.351, Protecting Seniors Access to Medicare Act of 2013 (All sections of full text) H.R.2027, Expanding Patients Access to Quality Care Act of 2013 (All sections of full text) H.R.3121, American Health Care Reform Act of 2013 (All sections of full text)H.R.3698, Two-Midnight Rule Delay Act of 2013 (All sections of full text) H.R.3796, Comprehensive Care Payment Innovation Act (All sections of full text) S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 (All sections of full text) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act. Discussions involving group purchasing organizations. Discussions regarding the status of construction of new veteran's affairs facility in the Denver metro area.

Client expense: Not reported · Firm income: $130,000

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Inpatient and outpatient hospital payments Issues and Legislation related to the Medicare Sustainable Growth Rate H.R.3698, Two-Midnight Rule Delay Act of 2013 S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014Issues Related to 340B Program Changes Issues Related to ICD-10 - No More Delay Issues Related to Reductions/Payment Cuts Re: Site-Neutral Payments & Graduate Medical Education Telehealth Issues & Legislation, Including: H.R. 3077, TELE-MED Act of 2013 H.R.5380, Latest Title: Medicare Telehealth Parity Act of 2014

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

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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

Organ Transplant Allocation Ebola Funding HR 3698 - 2 Midnight Rule Delay Act S 2082 - 2 Midnight Rule Delay Act S 577 - The Resident Physician Shortage Reduction Act HR 4188 - Establishing Beneficiary Equity in the Hospital Readmission Program Act FY 2015 Labor/HHS Appropriations

Client expense: Not reported · Firm income: $46,275

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L.112-25, The Budget Control Act (Sections regarding the impact of Medicare sequestration on hospitals) H.R.351, Protecting Seniors' Access to Medicare Act of 2013 (All sections of full text) H.R.2027, Expanding Patients' Access to Quality Care Act of 2013 (All sections of full text) H.R.3121, American Health Care Reform Act of 2013 (All sections of full text) H.R.3698, Two-Midnight Rule Delay Act of 2013 (All sections of full text) H.R.3796 Comprehensive Care Payment Innovation Act (All sections of full text) S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 (All sections of full text) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act Discussions involving group purchasing organizations Discussions regarding the status of construction of new veteran's affairs facility in the Denver metro area. P.L.113-146, Veterans Access, Choice, and Accountability Act of 2014 (Section 105. Prompt Payment by Department of Veterans Affairs) Monitored legislative branch oversight of executive branch-led Ebola treatment protocol for hospitals. Monitored draft House Ways and Means legislation entitled "The Hospital Improvements for Payment Act of 2014."

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

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of Health Care Reform Health care policy H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2942, Infectious Disease Hospital Hubs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE