Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

Funding for Graduate and Indirect Medical Education H.R. 4015; S. 2110: "SGR Repeal and Medicare Provider Payment Modernization Act of 2014" - To fix how physician payments are determined

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare payment policies for medical imaging; H.R. 4302, the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; Medicare payment reform.

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

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

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

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

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

Minimium Essential Coverage Provisions under the ACA Implementation/Expansion of CDC Falls Programs Direct Access under FEHBP Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits and Health Insurance Exchanges AHRQ provisions pertaining to PT H.R. 1427 Truth in Health Care Marketing Act H.R. 1098 TBI Reauthorization Act H.R. 3113 and S. 1516 ConTACT Act H.R. 3352 and S. 1546 Protecting Student Athletes from Concussions Act H.R. 3334 Medicare Adult Day Services Act H.R. 3221 Adult Day Center Enhancement Act H.R. 2817 Protect Patient Access to Quality Health Professionals Act H.R. 702 Access to Frontline Healthcare Act H.R. 3391 Indian Health Service Health Professionals Tax Fairness Act SGR Repeal or extension Physician Self-referral, S2110 H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.2115 American Cures Act H.R. 3877 Lymphadema Treatment Act White House Healthy Kids and Safe Sports Concussion Summit Health Information Technology Nominations to PCORI Methedology Committees Comments on GAO report on physician self-referral for physical therapy services CRPD Treaty S.2888 Excercise & Fitness for All Act

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

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

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

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

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

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, 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. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3662, the Mental Health Access Improvement Act of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 H.R. 5353, the Medicaid Parity Act of 2014 H.R. 5136, the Breaking Addiction Act of 2014 H.R. 5339, the Expanding Opportunities for Recovery Act of 2014 H.R. 5587, the Opioid Abuse Prevention and Treatment Act of 2014 Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015 (CMS-2014-0094-2364)

Client expense: $72,153 · Firm income: Not reported

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

S. 153, H.R. 274, the Mental Health First Aid Act of 2013 S. 195, H.R. 628, the Mental Health in Schools Act of 2013 H.R. 1100, the Mental Health on Campus Improvement Act S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, 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. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act H.R. 1427, the Truth in Healthcare Marketing Act of 2013 S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 S. 265, Community-Based Mental Health Improvements Act S. 648, Helping Educators Support All Students Act S.162, Justice and Mental Health Collaboration Act of 2013; S. 649, Safe Communities, Safe Schools Act of 2013 S. 2461: The CHIP Extension Act of 2014 S. 2728: The Community Based Medical Education Act H.R. 1615, A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037, the Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2775, No Subsidies Without Verification Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 2817, the Protect Patient Access to Quality Health Professionals Act of 2013 H.R. 2734, the Garrett Lee Smith Memorial Act Reauthorization of 2013 H.R. 2910, the Gun Violence Prevention and Reduction Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H Con Res 69, the Stop Harming Our Kids Resolution of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 H.R. 4574, the Strengthening Mental Health in Our Communities Act H.R. 4783, the Promoting Healthy Minds for Safer Communities Act H.R. 4581, the Parental Control Act of 2014 H.R. 5353, the Medicaid Parity Act of 2014 H.R. 5136, the Breaking Addiction Act of 2014 H.R. 5587, the Opioid Abuse Prevention and Treatment Act of 2014 H.R. 5339, the Expanding Opportunities for Recovery Act of 2014 H.R. 5364: The CHIP Extension and Improvement Act of 2014

Client expense: $72,153 · Firm income: Not reported

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

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

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

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

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

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

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

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

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

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

S. 1759 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2110 (HR 4015)- Medicare Sustainable Growth Rate: SGR Releal. Meicare reform to raise primary care payment. S. 2694 - Ensuring Access to Primary Care for Women and Children Act: Extending for 2 years the requirement that Medicaid programs pay primary care physicians at least as much as Medicare Does; Advocate for extension of Medicaid parity which expires at the end of 2014; Urge senators to co-sponsor S. 2694. S. 2978 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2229 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. No Bill Number - Oppose cuts to pre-resident payment for Teaching Health Center GME: Maintain the sustainability of the THCGME program. No Bill Number - Repeal Medicare Sustainable Growth Rate: Repeal SGR. Positive update and higher rate for Primary Care. No Bill Number - Medicare EHR incentive payments: Concerns over attestation process. No Bill Number - Medicare Advance Care Planning - Urge CMS to cover CPT codes for ACP services. No Bill Number - Medicare Physician Payment: Comments on 2015 final payments. No Bill Number - Teaching Health Centers Funding - Opposing reductions in per-resident payments to teaching health centers. No Bill Number - Medicare Evidence Development and Coverage Advisory Committee: Offering names of family physicians who could serve on the committee. No Bill Number - Children's Health Insurance Program - Supporting reauthorization of the Children's Health Insurance Program.

Client expense: $514,251 · 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), SENATE, Veterans Affairs, Dept of (VA)

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

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

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

S. 1759 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2110 (HR 4015)- Medicare Sustainable Growth Rate: SGR Releal. Meicare reform to raise primary care payment. S. 2694 - Ensuring Access to Primary Care for Women and Children Act: Extending for 2 years the requirement that Medicaid programs pay primary care physicians at least as much as Medicare Does; Advocate for extension of Medicaid parity which expires at the end of 2014; Urge senators to co-sponsor S. 2694. S. 2978 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2229 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. No Bill Number - Oppose cuts to pre-resident payment for Teaching Health Center GME: Maintain the sustainability of the THCGME program. No Bill Number - Repeal Medicare Sustainable Growth Rate: Repeal SGR. Positive update and higher rate for Primary Care. No Bill Number - Medicare EHR incentive payments: Concerns over attestation process. No Bill Number - Medicare Advance Care Planning - Urge CMS to cover CPT codes for ACP services. No Bill Number - Medicare Physician Payment: Comments on 2015 final payments. No Bill Number - Teaching Health Centers Funding - Opposing reductions in per-resident payments to teaching health centers. No Bill Number - Medicare Evidence Development and Coverage Advisory Committee: Offering names of family physicians who could serve on the committee. No Bill Number - Children's Health Insurance Program - Supporting reauthorization of the Children's Health Insurance Program.

Client expense: $514,251 · 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), SENATE, Veterans Affairs, Dept of (VA)

HR 487, Primary Care Workforce Access Improvement Act, Urge House to cosponsor bill that would create GME pilot project to train primary care doctors, urge Senate offices to sponsor bill; urge W&M offices to discuss during March 2014 budget hearing, GME reform increase primary care physician training, pilot test alternatives to GME payment to increase PCP training.HR 2305, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2810, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2867, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2969, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 3306, Telehealth Enhancement Act, Defining the home base for telehealth reimbursement to incluse family medicine offices. HR 4015, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4209, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4302, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. HR 4418, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4543, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1123, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1184, Treat and Reduce Obesity Act, Seeking House and Senate cosponsors for obesity legislation. S. 1318, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1759, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 1769, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1871, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1978, Increasing Primary Care Access Act, Family physician workforce, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medical Education program, increase family physician workforce. S. 2000, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. S. 2110, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. S. 2122, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 2229, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 2415, Seeking House and Senate cosponsors for obesity legislation. No Bill Number, SGR Repeal and Replacement process, Advocate for SGR repeal and new physician payment system that pays for value and primary care. No Bill Number, Medicaid Primary Care Bonus, Advocate for extension of the Medicaid bonus which expires at the end of 2014. No Bill Number, Medicare Primary Care Incentive Payment, Urge Ways and Means members to discuss at annual MedPac hearing. No Bill Number, Telemedicine,advocate for AAFP policies to be included in a potential bipartisan telehealth bill. No Bill Number, Medicare Site Neutral Payments; advocate for AAFP policies to be included in conncection with MedPac hearing. No Bill Number, Extend Medicare/medicare parity for primary care services, Extend increase in Medicaid payments for primary care services to Medicare levels beyond 2015. No Bill Number, Direct Primary Care, Primary care model of retainer-based practice. No Bill Number, Medicare physician payment reform of the SGR, 2014 converstion factor. No Bill Number, Repeal SGR, Positive update and higher rate for primary care.No Bill Number, Site-neutral payment for medical services, Support site-neutral payment by CMS for medical services. No Bill Number, First Fridays Meetings, Provider outreach group for Affordable Care Act, provider and open enrollment issues.

Client expense: $627,558 · Firm income: Not reported

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

S. 1759 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2110 (HR 4015)- Medicare Sustainable Growth Rate: SGR Releal. Meicare reform to raise primary care payment. S. 2694 - Ensuring Access to Primary Care for Women and Children Act: Extending for 2 years the requirement that Medicaid programs pay primary care physicians at least as much as Medicare Does; Advocate for extension of Medicaid parity which expires at the end of 2014; Urge senators to co-sponsor S. 2694. S. 2978 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2229 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. No Bill Number - Oppose cuts to pre-resident payment for Teaching Health Center GME: Maintain the sustainability of the THCGME program. No Bill Number - Repeal Medicare Sustainable Growth Rate: Repeal SGR. Positive update and higher rate for Primary Care. No Bill Number - Medicare EHR incentive payments: Concerns over attestation process. No Bill Number - Medicare Advance Care Planning - Urge CMS to cover CPT codes for ACP services. No Bill Number - Medicare Physician Payment: Comments on 2015 final payments. No Bill Number - Teaching Health Centers Funding - Opposing reductions in per-resident payments to teaching health centers. No Bill Number - Medicare Evidence Development and Coverage Advisory Committee: Offering names of family physicians who could serve on the committee. No Bill Number - Children's Health Insurance Program - Supporting reauthorization of the Children's Health Insurance Program.

Client expense: $2,438,717 · 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), SENATE, Veterans Affairs, Dept of (VA)

Medicare audit issues related to reimbursement and implementation of the DMEPOS competitive bidding program; Implementing P.L 113-93 the Protecting Access to Medicare Act of 2014; S. 2110 Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; S.2000 SGR Repeal and Medicare Provider Payment Modernization Act of 2014; S.1871 SGR Repeal and Medicare Beneficiary Access Act of 2013; Ways and Means fraud and abuse legislation; GAO and OIG reports related to DMEPOS; DMEPOS Prior Authorization proposed rule; DMEPOS Medicare payment proposed rule and final rule.

Client expense: Not reported · Firm income: $37,500

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

S. 1405 Medicare Ambulance Access Act of 2013; HR 4302, the Protecting Access to Medicare Act of 2014 (P.L. 113-93); S. 2110 Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; S.2000 SGR Repeal and Medicare Provider Payment Modernization Act of 2014; S.1871 SGR Repeal and Medicare Beneficiary Access Act of 2013; H.R. 5460, the Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2014; Implementation of P.L. 112-240, American Taxpayer Relief Act; Implementation of P.L. 111-148, Patient Protection and Affordable Care Act; Implementation of P.L. 111-152, Health Care and Education Reconciliation Act of 2010; issues surrounding GAO and MedPAC reports; Medicare ambulance reimbursement issues, including CMS-1612-P: Medicare Program: Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015; Proposed Rule & Final Rule; HR 5460 "Medicare Ambulance Access, Fraud Prevention, and Re- form Act of 2014"

Client expense: Not reported · Firm income: $37,500

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

CB-ISNP (community-based I-SNP) - HCBS flexibility; Medicare and Medicaid dual eligible integration; Performance evaluation/quality oversight; SNP (Special Needs Plans) reauthorization; S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage/CMS-Hierarchical Condition Category Risk Assessment (CMS-HCC RA) payment model; Medicare and Medicaid dual eligible integration; performance evaluation/quality oversight; SNP (Special Needs Plans) reauthorization; social determinants of health research/Medicare Advantage Star Ratings program; S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare funding/reimbursement pressures; Medicaid rate sufficiency; Medicaid expansion; Medicare Advantage offset;Two Midnights - hospital payment policy; S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014, issues relating to longtern sustainable growth rate (SGR)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to plan design, reimbursement and cost savings proposals. H.R. 2810 - The Medicare Patient Access and Quality Improvement Act of 2013 H.R. 4302 - Protecting Access to Medicare Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare Part D and anti-pharmacy benefit manager legislation. Other issues include health care delivery system reforms, the sale of tobacco products, cost containment, medication adherence, restrictions on pharmacy benefit manager audit practices, and pharmacy benefit manager cost saving tools like mail ordering and generics. H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to health plan policy as a part of the Affordable Care Act, including Medicare Advantage and quality measurement. Issues related to Sustainable Growth Rate (SGR) reform legislation. Issues related to telemedicine. H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to health plan policy as a part of the Affordable Care Act, including Medicare Advantage and quality measurement. Issues related to Sustainable Growth Rate (SGR) reform legislation. Issues related to telemedicine. H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1759 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2110 (HR 4015)- Medicare Sustainable Growth Rate: SGR Releal. Meicare reform to raise primary care payment. S. 2694 - Ensuring Access to Primary Care for Women and Children Act: Extending for 2 years the requirement that Medicaid programs pay primary care physicians at least as much as Medicare Does; Advocate for extension of Medicaid parity which expires at the end of 2014; Urge senators to co-sponsor S. 2694. S. 2978 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2229 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. No Bill Number - Oppose cuts to pre-resident payment for Teaching Health Center GME: Maintain the sustainability of the THCGME program. No Bill Number - Repeal Medicare Sustainable Growth Rate: Repeal SGR. Positive update and higher rate for Primary Care. No Bill Number - Medicare EHR incentive payments: Concerns over attestation process. No Bill Number - Medicare Advance Care Planning - Urge CMS to cover CPT codes for ACP services. No Bill Number - Medicare Physician Payment: Comments on 2015 final payments. No Bill Number - Teaching Health Centers Funding - Opposing reductions in per-resident payments to teaching health centers. No Bill Number - Medicare Evidence Development and Coverage Advisory Committee: Offering names of family physicians who could serve on the committee. No Bill Number - Children's Health Insurance Program - Supporting reauthorization of the Children's Health Insurance Program.

Client expense: Not reported · Firm income: $2,438,717

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), SENATE, Veterans Affairs, Dept of (VA)

Proposals to reform physician payment H.R. 1733: Good Samaritan Health Professionals Act of 2013 H. R. 1827: Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 Trauma FundingH.R.4080 Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 4015 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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2500/S. 1137 - Ambulatory Surgical Center Quality and Access Act of 2013 H.R. 1070 - Removing Barriers to Colorectal Cancer Screening Act of 2013 Reform of Medicare payments to ASCs Reform of Medicare regulations dealing with ASCs 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. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 1331 - Electronic Health Records improvement Act H.R. 5556 - Electronic Health Fairness Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment Act of 2013

Client expense: $163,606 · Firm income: Not reported

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

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

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

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

Minimium Essential Coverage Provisions under the ACA Implementation/Expansion of CDC Falls Programs Direct Access under FEHBP Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits and Health Insurance ExchangesAHRQ provisions pertaining to PT H.R. 1427 Truth in Health Care Marketing Act H.R. 1098 TBI Reauthorization Act H.R. 3113 and S. 1516 ConTACT Act H.R. 3352 and S. 1546 Protecting Student Athletes from Concussions Act H.R. 3334 Medicare Adult Day Services Act H.R. 3221 Adult Day Center Enhancement Act H.R. 2817 Protect Patient Access to Quality Health Professionals Act H.R. 702 Access to Frontline Healthcare Act H.R. 3391 Indian Health Service Health Professionals Tax Fairness Act SGR Repeal or extension Physician Self-referral, S2110 H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.2115 American Cures Act H.R. 3877 Lymphadema Treatment Act White House Healthy Kids and Safe Sports Concussion Summit Health Information Technology Nominations to PCORI Methedology Committees Comments on GAO report on physician self-referral for physical therapy services CRPD Treaty S.2888 Excercise & Fitness for All Act

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.36 - Health Care Safety Net Enhancement Act of 2013 H.R.235 - Veteran Emergency Medical Technician Support Act of 2013 H.R.351 - Protecting Seniors' Access to Medicare Act of 2013 H.R.574 - Medicare Physician Payment Innovation Act of 2013 H.R.647 - Achieving a Better Life Experience (ABLE) Act of 2014 H.R.809 - Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2013 H.R.1098 - Traumatic Brain Injury Reauthorization Act of 2013 H.R.1201 - Training Tomorrow's Doctors Today Act H.R.1263 - Excellence in Mental Health Act H.R.1179 - Improving Access to Medicare Coverage Act of 2013 H.R.1180 - Resident Physician Shortage Reduction Act of 2013 H.R.1487 - Improved Health Care Lower Cost Act of 2013 H.R.1838 - Enhanced Access to Medicaid Services H.R.2186 - Verifying Authority and Legality In Drug Compounding Act of 2013 H.R.2900 - Offering Patients True Individualized Options Now (Option Act of 2013) H.R.2300 - Empowering Patients First Act of 2013 H.R.2810 - Medicare Patient Access and Quality Improvement Act of 2013 H.R.3392 - Patient Safety and Drug Abuse Prevention Act H.R.3528 - National All Schedules Prescription Electronic Reporting Reauthorization Act of 2013 H.R.3548 - Improving Trauma Care Act of 2013 H.R.3717 - Helping Families in Mental Health Crisis Act of 2013 H.R.4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.4080 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.4106 - Saving Lives, Saving Costs Act H.R.4169 - Stop Overdose Stat Act H.R.4574 - Strengthening Mental Health in Our Communities Act of 2014 H.R.5460 - Medicare Ambulance Access, Fraud Prevention and Reform Act of 2014 S.44 - Medical Care Access Protection (MCAP) Act of 2013 S.264 - Excellence in Mental Health Act S.265 - Community-Based Mental Health Infrastructure Improvements Act S.313 - Achieving a Better Life Experience (ABLE) Act of 2014 S.328 - Strengthening Rural Access to Emergency Services Act S.351 - Protecting Seniors' Access to Medicare Act of 2013 S.569 - Improving Access to Medicare Coverage Act of 2013 S.577 - Resident Physician Shortage Reduction Act of 2013 S.755 - Enhanced Access to Medicaid Services S.961 - Health Care Safety Net Enhancement Act of 2013 S.1871 - SGR Repeal and Medicare Beneficiary Access of 2013 S.2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2240 - Medicare Choices Empowerment and Protection Act S.2400 - Field EMS Innovation Act S.2405 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.2406 - Improving Trauma Care Act of 2014 S.2501 - Hospital Readmission Accuracy and Accountability Act S.2539 - Traumatic Brain Injury Reauthorization Act of 2014 S.2755 - Overdose Prevention Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, 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. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3662, the Mental Health Access Improvement Act of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 H.R. 5353, the Medicaid Parity Act of 2014 H.R. 5136, the Breaking Addiction Act of 2014 H.R. 5339, the Expanding Opportunities for Recovery Act of 2014 H.R. 5587, the Opioid Abuse Prevention and Treatment Act of 2014 Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015 (CMS-2014-0094-2364)

Client expense: $72,153 · Firm income: Not reported

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

S. 153, H.R. 274, the Mental Health First Aid Act of 2013 S. 195, H.R. 628, the Mental Health in Schools Act of 2013 H.R. 1100, the Mental Health on Campus Improvement Act S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, 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. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act H.R. 1427, the Truth in Healthcare Marketing Act of 2013 S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 S. 265, Community-Based Mental Health Improvements Act S. 648, Helping Educators Support All Students Act S.162, Justice and Mental Health Collaboration Act of 2013; S. 649, Safe Communities, Safe Schools Act of 2013 S. 2461: The CHIP Extension Act of 2014 S. 2728: The Community Based Medical Education Act H.R. 1615, A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037, the Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2775, No Subsidies Without Verification Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 2817, the Protect Patient Access to Quality Health Professionals Act of 2013 H.R. 2734, the Garrett Lee Smith Memorial Act Reauthorization of 2013 H.R. 2910, the Gun Violence Prevention and Reduction Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H Con Res 69, the Stop Harming Our Kids Resolution of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 H.R. 4574, the Strengthening Mental Health in Our Communities Act H.R. 4783, the Promoting Healthy Minds for Safer Communities Act H.R. 4581, the Parental Control Act of 2014 H.R. 5353, the Medicaid Parity Act of 2014 H.R. 5136, the Breaking Addiction Act of 2014 H.R. 5587, the Opioid Abuse Prevention and Treatment Act of 2014 H.R. 5339, the Expanding Opportunities for Recovery Act of 2014 H.R. 5364: The CHIP Extension and Improvement Act of 2014

Client expense: $72,153 · Firm income: Not reported

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

Funding for Graduate and Indirect Medical Education H.R. 4015; S. 2110: "SGR Repeal and Medicare Provider Payment Modernization Act of 2014" - To fix how physician payments are determined H.R. 3698 - Two-Midnight Rule Delay Act of 2013 - to delay the enforcement of the "two-midnight" rule for Medicare patients

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

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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R.3830/S.1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) extension and CHIP Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice - Final 2014 CMS Guidance. H.R.5294, Health Equity & Accountability Act of 2014 - Addresses health care disparities; no endorsement due to budget impact. Medicare Advantage- Answered questions from some Hill offices. (no bill) Medicare Supplemental Insurance - Stated opposition to the elimination of first dollar coverage. (no bill) Discussed LTSS issues, including financing. (no bill)Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013. Discussed Medicaid expansion and estate recovery. (no bill) S. 2491, Discussed Medicare Protection Act. Discussed concern about CMS guidance on prescription drugs for medicare beneficiaries receiving hospice and coordination between hospice providers and medicare Part D sponsors. (no bill) Discussed long-term services and supports in Hill briefings. (no bill) H.R. 1173 - Discussed advance care planning, CMS payment for advance care planning, advanced illness, and Personalize Your Care Act.H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Discussed CMS information regarding healthcare marketplaces. H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) H.R. 83, Consolidated and Further Continuing Appropriations, 2015 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.(no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed You've Earned A Say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). PL.111-148 - Discussed implementation of provision to require reporting of nursing home staffing data based on payroll data and executive actions related to nursing homes, IMPACT Act, PL 113-185).. Discussed the draft legislation on Medicare fraud and abuse. Protecting the Integrity of Medicare Act. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 3830/S. 1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice-Final 2014 CMS Guidance. Discussed the Protecting Integrity of Medicare Act. (no bill) H.R.5435, Home Infusion Site of Care Act - Sent letter of endorsement H.R. 5958 - Discussed the ACO Improvement Act. H.J. Res. 124, Continuing Appropriations Resolution - Lobbied to protect funding levels for CMS program management under Continuing Resolution. H.R. 1179/S. 569 - Discussed observation impace on Medicare beneficiaries, counting time in observation toward Medicare's three-day inpatient hospital stay requirement for Medicare skilled nursing facility coverage, and the Improving Access to Medicare Coverage Act (CMS & MedPAC). PL. 113-295 - Responded to inquiry about Medicare offsets on Achieving a Better Life Expense Act.Discussed Medicare Advantage. (no bill) Discussed H.R. 3616, Protecting Seniors from Healthcare Fraud Act. Discussed observation care and "two-midnight rule". (no bill) H.R. 1070, the Removing Barriers to Colorectal Cancer Screening Act - Discussed and sent letter of endorsement to bill. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740, Medicaid Drug Savings Act - Discussed the requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed pending U.S. Trade agreement negotiations, including trade promotional or "fast track" authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S.1871/H.R. 4015/S.2110 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. H.R. 4418, The Expanding Availability of Medicare Data Act - Sent letter of endorsement. Discussed Medicare data and billing transparency. (no bill) Discussed socio-economic risk adjustment. (no bill) S. 2240 - Discussed Medicare Choices Empowerment and Protection Act. H.R. 3024 - Discussed the Medicare Common Access Card Act. Discussed Medicare expansion. (no bill) Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). Discussed transparency in healthcare. (no bill) Discussed Medicaid managed care regulations. (CMS, no bill) PL.111-148 - Discussed long-term services and supports broadly and Older Americans Act. Submitted comments on Medicare Physician fee schedule final rule and advance care planning (CMS - 1612-FC). Discussed Medicare enrollment and notification of eligibility. (no bill) Discussed Medicare in-office ancillary services exception. (no bill)

Client expense: $2,180,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Congressional Budget Office (CBO), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

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

S. 689 - The Mental Health Awareness and Improvement Act of 2013 S.649 - The Safe Communities, Safe Schools Act of 2013 H.R. 2957 - Behavioral Health Information Technology Act of 2013 S. 1517 - Behavioral Health Information Technology Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.R.3717 - Helping Families in Mental Health Crisis Act of 2013 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), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

S. 689 - The Mental Health Awareness and Improvement Act of 2013 S.649 - The Safe Communities, Safe Schools Act of 2013 H.R. 2957 - Behavioral Health Information Technology Act of 2013 S. 1517 - Behavioral Health Information Technology Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.R.3717 - Helping Families in Mental Health Crisis Act of 2013 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), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Record (EHR) Incentive Program in 2015 - Request HHS provide for a shortened, 90-day EHR reporting period in 2015, which would give time for providers to continue their transition without having to drop out of the program. Children's Health Insurance Program (CHIP) - Urged Congress to take action and continue funding the programs. DSH Reduction relief Act of 2013 (S.1555 and H.R. 1920) Urged Congress to support legislation which would delay scheduled reductions to the Medicare and Medicaid Disproportionate Share Hospital (DSH) programs to allow states additional time to determine the level of health care coverage expansions. S. 2110 - the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 - Urged Senators to enact legislation to repeal and replace the Medicare physician payment formula, specifically the sustainable growth rate (SGR) to ensure adequate Medicare reimbursement for physicians who treat seniors. Urged the Department of Health and Human Services to continue to promote the Medicaid final rule which would ensure that individual's rights and protections under Medicaid are upheld when considering state Medicaid 1115 waivers. Urged Congress to extend the HEN program for at least an additional year. S. 569 and H.R. 1179 Improving Access to Medicare Coverage Act of 2013 - The bill amends the Medicare statute's definition of "post hospital extended care services" to clarify that Medicare beneficiaries in observation are deemed inpatients in the hospital.

Client expense: $152,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, White House Office