Medicare Choices Empowerment and Protection Act

H.R.5780, Protecting Integrity of Medicare Act of 2014 (PIMA) H.R. 5860, the Small Business Healthcare Relief Act H.R. 83, CRomnibus - Consolidated & Further Continuing Appropriations Act, 2015 H.J. Res 124, Continuing Appropriations Resolution, 2015 H.R. 4015/S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.2966, Critical Care Assessment and Improvement Act of 2014 H.R. 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014. S.2240, Medicare Choices Empowerment and Protection Act H.R. 4190, To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services H.R. 2663/S. 1422 Preventive Health Savings Act H.R. 5644 Medicare CGM Access Act of 2014

Client expense: $140,000 · Firm income: Not reported

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

H.R.5780, Protecting Integrity of Medicare Act of 2014 (PIMA) H.R. 83, CRomnibus - Consolidated & Further Continuing Appropriations Act, 2015 H.J. Res 124, Continuing Appropriations Resolution, 2015 H.R. 4015/S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014. S.2240, Medicare Choices Empowerment and Protection Act H.R. 4190, To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services H.R. 5644 Medicare CGM Access Act of 2014

Client expense: $140,000 · Firm income: Not reported

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

Hydraulic fracturing matters; Indian energy legislative provisions (H.R.1548, H.R.2728, H.R.1965, and S.2132); BLM/APD fee legislation (S.2240); onshore and offshore energy development; and related regulations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; Device Tax Legislation.HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act. H.Con.Res. 25 S.Con. Res. Budget Resolutions S.886, S. 1013, H.R.845, H.R. 2024 Intellectual Property

Client expense: $550,000 · Firm income: Not reported

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 implementation of regulations regarding minimum wage and overtime for home care workers and consumer-directed care. (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 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 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) Discussed Medicaid and asset transfers. (no bill) H.R.4994/S. 2553, Improving Medicare Post-Acute Care Transformation Act of 2014 - Discussed the bill and AARP support for the bill. Shared our letter of support. 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) H.R. 1179/S.569 - Submitted statement for the record for Senate Aging Committee hearing on Observation Improving Access to Medicare Coverage Act and Notice of Observation Treatment and Implication for Care Eligibility Act (H.R. 5232). Discussed aging in place, HCBS, family caregiving. (no bill)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) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) Labor, Health and Human Services Appropriations Act, 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. 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.R. 5232 - Discussed and sent letter on the Notice of Observation Treatment and Implication for Care Eligibility Act. Met with Centers for Medicare and medicaid services to discuss three-day stay requirement for medicare skilled nursing coverage. H.J. Res. 124, Continuing Appropriations Resolution - Lobbied to protect funding levels for CMS program management under Continuing Resolution. Discussed coordination with hospice providers and Medicare Part D plans guidance for Medicare beneficiaries receiving hospice. (no bill) 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). Discussed caucus for military/veteran family caregivers and support for family caregivers. (no bill) Discussed draft working paper on impact of observation on Medicare beneficiary out of pocket. (no bill)Discussed District of Columbia EPD Medicaid HCBS waiver. (no bill) H.R. 5232 - Discussed legislation and shared letter of support for the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act of 2014. 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. H.R. 4673-Discussed the Bundling and Coordinating Post Acute Care (BACPAC) Act and shared views on post-acute care return. Discussed Medicare expansion. (no bill) Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). S. 2361, Discussed Stop Schemes and cons against Medicare and seniors. Discussed transparency in healthcare. (no bill) Discussed LTSS Hill briefing series. (no bill) Met with CMS on observation status. (no bill) Submitted comment letter to CMS on the FY2015 Medicare Hospice proposed regulation. Shared comment letter with some Hill staff. H.R. 4994/S.2553 - Shared letter of support for Improving Medicare Post-Acute Care Transformation Act and discussed the status of the bill. Discussed long-term survey and supports Hill briefings. (no bill) Submitted comment letter to CMS on the FY 2015 Medicare Home Health proposed regulation. Shared draft working paper on impact of observation on Medicare beneficiary out of pocket cost. (no bill) Responded to inquiry on observation. (no bill)

Client expense: $2,380,000 · 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

Hydraulic fracturing matters; Indian energy legislative provisions (H.R.1548, H.R.2728, H.R.1965, and S.2132); BLM/APD fee legislation (S.2240); onshore and offshore energy development; and related regulations.

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

Government targets: Bureau of Indian Affairs (BIA), Energy, Dept of, 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.297 - Children's Hospital GME Support Reauthorization Act of 2013 H.R.351 - Protecting Seniors' Access to Medicare Act of 2013H.R.574 - Medicare Physician Payment Innovation Act of 2013 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.3230 Veterans' Access to Care Through Choice, Accountability and Transparency Act of 2014 H.R.3392 - Patient Safety and Drug Abuse Prevention Act H.R.3527 Poison Center Network 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.4290 Wakefield Act of 2014 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.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.1719 Poison Center Network Act S.1871 SGR Repeal and Medicare Beneficiary Access of 2013 S.2110 Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2154 Emergency Medical Services for Children Reauthorization 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.2450 Veterans' Access to Care Through Choice, Accountability and Transparency Act of 2014 S.2501 Hospital Readmission Accuracy and Accountability Act S.2539 Traumatic Brain Injury Reauthorization Act of 2014

Client expense: $291,064 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.351 - Protecting Seniors' Access to Medicare Act of 2013 H.R.574 - Medicare Physician Payment Innovation Act of 2013 H.R.1179 - Improving Access to Medicare Coverage Act of 2013 H.R.1250 - Medicare Audit Improvement Act 2013H.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.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: $291,064 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5380 The Medicare Telehealth Parity Act of 2014 S. 2552 The Medicare Advantage Participants Bill of Rights Act H.R. 4998, The Medicare Advantage Participants Bill of Rights Act S. 2553 The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) H.R. 4994, The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) S. 1932 The Better Care, Lower Cost Act H.R. 3890, The Better Care, Lower Cost Act S. 1422 The Preventive Health Savings Act H.R. 2663, The Preventive Health Savings Act H.R. 5279, The Sugar-Sweetened Beverages Tax (SWEET) Act S.2574, The Healthy Families Act of 2014 H.R. 1024, The Medication Therapy Management Empowerment Act S. 2240, The Medicare Choices Empowerment and Protection Act 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 HR. 4418, the Expanding the Availability of Medicare Data Act H.R. 2843 Medicare Data Access for Transparency and Accountability Act S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 3077, TELEmedicine for MEDicare (TELE-MED) Act H.R. 4190, a bill that would will allow Medicare reimbursement for Part B services performed by a pharmacist in underserved communities, among other activities. H.R.1070, Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 1074 National Diabetes Clinical Care Commission Bill S. 539, National Diabetes Clinical Care Commission Bill

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

U.S. HOUSE OF REPRESENTATIVES Contacts in support of repealing the Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would (continued)1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts regarding H.R. 1173, the Personalize Your Care Act of 2013, because 1) it provides for inadequate oversight regarding the creation of advance planning materials, websites, etc. in order to protect against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, 2) unmonitored practitioner consultations could lead to patients forgoing treatment they would otherwise have wanted, and 3) it includes adverse changes to the Assisted Suicide Funding and Restriction Act. Contacts in regard to potential health reform legislation (not introduced) over concerns related to 1) the authority of any sort of health care commissions ability to restrict access to life-saving care, 2) premium price controls that might reduce the ability of insurance to cover life-saving care, 3) tax increases on health care or health insurance that create incentives for employers to significantly reduce health insurance plans, 4) efforts to prevent private health care spending from keeping up with medical inflation, and 5) malpractice limits being made applicable to intentional denial of treatment for discriminatory reasons. Contacts regarding legislation (not introduced) regarding advance directives to ensure that legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration. (continued)U.S. Senate Contacts in support of repealing The Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would 1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts in support of S. 2064, the Repeal Rationing in Support of Life Act, because it would 1) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 2) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment. Contacts regarding legislation (not introduced) regarding encouraging advance directives for Medicare recipients so long as legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration. Contacts regarding legislation S.1439, the Care Planning Act of 2013, regarding advance care planning because of 1) the inadequacy of oversight regarding the creation of advance planning materials, websites, etc. in order to protection against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, and 2) the creation of interdisciplinary teams under Medicare and Medicaid to engage in advance care planning and counseling without adequate oversight that they could seek influence patients or their representative to forego life-saving medical treatment because of a bias toward a quality of life ideology and/or to save money. Contacts regarding legislation S.2240 Medicare Choices Empowerment and Protection Act because of 1) the need for a neutral website where all the various advance directive forms would be available and 2) the potential that portability provisions could force states to recognize directives inconsistent with their substantive law. (continued)Contacts in regard to potential health reform legislation (not introduced) over concerns related to 1) the authority of any sort of health care commissions ability to restrict access to life-saving care, 2) premium price controls that might reduce the ability of insurance to cover expensive life-saving care, 3) tax increases on health care or health insurance that create incentives for employers to significantly reduce health insurance plans, 4) efforts to prevent private health care spending from keeping up with medical inflation, and 5) malpractice limits being made applicable to intentional denial of treatment for discriminatory reasons. Contacts regarding legislation (not introduced) regarding advance directives to ensure that legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration.

Client expense: $106,475 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocacy of advance care planning; electronic advance directives S.2240-- Medicare Choices Empowerment and Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; Device Tax Legislation.HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act. H.Con.Res. 25 S.Con. Res. Budget Resolutions S.886, S. 1013, H.R.845, H.R. 2024 Intellectual Property

Client expense: $900,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; Device Tax Legislation.HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act. H.Con.Res. 25 S.Con. Res. Budget Resolutions S.886, S. 1013, H.R.845, H.R. 2024 Intellectual Property

Client expense: $900,000 · Firm income: Not reported

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 implementation of regulations regarding minimum wage and overtime for home care workers and consumer-directed care. (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 and CHIP Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice - Final 2014 CMS Guidance.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. H.R. 1173 - Discussed Personalize Your Care Act. Discussed Medicaid expansion and estate recovery. (no bill) Discussed Medicaid and asset transfers. (no bill) Discussed the Improving Medicare Post-Acute Care Transformation Act of 2014 and provided feedback on the draft bill. (no bill number at the time, but later bill number was H.R. 4944/S. 2553) S. 2491, Discussed Medicare Protection Act. Submitted comment letter on FYIS Medicare Skilled Nursing Facility payment rule. (no bill) 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)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 comments regarding Medicare and You handbook. (no 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) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) Labor, Health and Human Services Appropriations Act, 2014 - 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.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) Discussed nursing home staffing data in meeting with CMS. (no bill) Discussed advanced care planning, Welcome to Medicare visit, and Medicare wellness visits. Discussed language access in managed long-term services and supports in meeting with the HHS Office for Civil Rights. S. 2240, Discussed Medicare Choices Empowerment and Protection Act. S. 1439, Discussed support for Care Planning Act. Discussed LTSS Scorecard and reserving a room/logistics for Hill briefing on the LTSS Scorecard. (no bill). Discussed managed LTSS and language access. (no bill) H.R. 3024, Discussed the Medicare Common Access Card Act. H.R. 9673, Discussed the Bundling and Coordinating Post Acute Care (BACPAC) Act and shared views on post-acute care return. Discussed Medicare expansion. (no bill) H.R. 1179/S. 569, Improving Access to Medicare Coverage Act - Submitted written statement for the record for the current hospital ---in the Medicare program hearings. Shared draft witness questions with some subcommittee members and committee staff. Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). S. 2361, Discussed Stop Schemes and cons against Medicare and seniors. Invited Hill staff to attend the LTSS Scorecard briefing. (no bill) Participated in a roundtable discussion on long-term services and supports. (no bill) Discussed Welcome to Medicare Visit and advance care planning. (no bill) Discussed transparency in healthcare. (no bill) Discussed New York State Community first choice option and workforce issues. (no bill)

Client expense: $2,360,000 · 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), 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

U.S. HOUSE OF REPRESENTATIVES Contacts in support of repealing the Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would (continued)1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts in regards to H.R. 3121, The American Health Care Reform Act of 2013 because of concerns it 1) replaces tax preference for employer-provided health insurance with a deduction for health insurance premiums and indexes the deductibility limit for health insurance to general inflation measured by the Consumer Price Index (CPI), rather than to medical inflation, which could lead to reduction in health insurance plan benefits, and 2) may suppress private, nongovernmental, health care spending beyond a governmentally imposed limit. Contacts regarding H.R.2300, the Empowering Patients First Act of 2013, because 1) the use of best practices guidelines could establish a federally managed limit on what medical treatment is expected to be provided, and set a bureaucratically dictated standard of care and 2) clarification is needed to ensure malpractice limits are not being made applicable to intentional denial of treatment for discriminatory reasons. Contacts regarding H.R. 1173, the Personalize Your Care Act of 2013, because 1) it provides for inadequate oversight regarding the creation of advance planning materials, websites, etc. in order to protect against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, 2) unmonitored practitioner consultations could lead to patients forgoing treatment they would otherwise have wanted, and 3) it includes adverse changes to the Assisted Suicide Funding and Restriction Act. Contacts in regard to potential health reform legislation (not introduced) over concerns related to 1) the authority of any sort of health care commissions ability to restrict access to life-saving care, 2) premium price controls that might reduce the ability of insurance to cover life-saving care, 3) tax increases on health care or health insurance that create incentives for employers to significantly reduce health insurance plans, 4) efforts to prevent private health care spending from keeping up with medical inflation, and 5) malpractice limits being made applicable to intentional denial of treatment for discriminatory reasons. (continued)U.S. Senate Contacts in support of repealing The Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would 1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts in support of S. 2064, the Four Rationiners Repeal Act of 2014, because it would 1) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 2) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment. (continued)Contacts regarding legislation (not introduced) regarding encouraging advance directives for Medicare recipients so long as legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration. Contacts regarding legislation S.1439, the Care Planning Act of 2013, regarding advance care planning because of 1) the inadequacy of oversight regarding the creation of advance planning materials, websites, etc. in order to protection against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, and 2) the creation of interdisciplinary teams under Medicare and Medicaid to engage in advance care planning and counseling without adequate oversight that they could seek influence patients or their representative to forego life-saving medical treatment because of a bias toward a quality of life ideology and/or to save money. Contacts regarding legislation S.2240 Medicare Choices Empowerment and Protection Act because of 1) the need for a neutral website where all the various advance directive forms would be available and 2) the potential that portability provisions could force states to recognize directives inconsistent with their substantive law. Contacts regarding the Patient Choice, Affordability, Responsibility, and Empowerment Act (or Patient Care Act) because of concerns it 1) replaces tax preference for employer-provided health insurance with a deduction for health insurance premiums and indexes the deductibility limit for health insurance to general inflation measured by the Consumer Price Index (CPI), rather than to medical inflation, which could lead to reduction in health insurance plan benefits, and 2) may suppress private, nongovernmental, health care spending beyond a governmentally imposed limit. Contacts in regard to potential health reform legislation (not introduced) over concerns related to 1) the authority of any sort of health care commissions ability to restrict access to life-saving care, 2) premium price controls that might reduce the ability of insurance to cover expensive life-saving care, 3) tax increases on health care or health insurance that create incentives for employers to significantly reduce health insurance plans, 4) efforts to prevent private health care spending from keeping up with medical inflation, and 5) malpractice limits being made applicable to intentional denial of treatment for discriminatory reasons. Contacts regarding legislation (not introduced) regarding advance directives to ensure that legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration. Contacts regarding legislation (not introduced) regarding advance directives to ensure that legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration.

Client expense: $79,421 · 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.297 - Children's Hospital GME Support Reauthorization Act of 2013 H.R.351 - Protecting Seniors' Access to Medicare Act of 2013H.R.574 - Medicare Physician Payment Innovation Act of 2013 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.3230 Veterans' Access to Care Through Choice, Accountability and Transparency Act of 2014 H.R.3392 - Patient Safety and Drug Abuse Prevention Act H.R.3527 Poison Center Network 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.4290 Wakefield Act of 2014 H.R.4574 Strengthening Mental Health in Our Communities 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.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.1719 Poison Center Network Act S.1871 SGR Repeal and Medicare Beneficiary Access of 2013 S.2110 Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2154 Emergency Medical Services for Children Reauthorization 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.2450 Veterans' Access to Care Through Choice, Accountability and Transparency Act of 2014 S.2501 Hospital Readmission Accuracy and Accountability Act

Client expense: $646,873 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.351 - Protecting Seniors' Access to Medicare Act of 2013 H.R.574 - Medicare Physician Payment Innovation Act of 2013 H.R.1179 - Improving Access to Medicare Coverage Act of 2013 H.R.1250 - Medicare Audit Improvement Act 2013H.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 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: $646,873 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to reimbursement for Medicare hospice services. Medicare hospice surveys, H.R. 2302 / S. 1053, The Hospice Evaluation and Legitimate Payment Act of 2013. Issues concerning coverage of related prescription drugs under the Medicare hospice benefit. S. 2240, The Medicare Choices Empowerment and Protection Act as it relates to Advance Directives.

Client expense: Not reported · Firm income: $45,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Senators Coburn and Coons introduced legislation, the Medicare Choices Empowerment & Protection Act (S. 2240), that would allow Medicare beneficiaries to voluntarily adopt an advance medical directive to guide the care they receive.

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

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

Discussed importance of high-quality electronic advance medical directives (ADs) for all adults over 18 years old that can be accessed 24 hrs/day, 7 days/week by patients, physicians, and hospitals anywhere in the world as part of the patient's electronic health record (EHR). Seeking consideration of ADs as a core requirement under the Stage 3 Meaningful Use Rule, as recommended by the HIT Policy Committee, Joint Commission, and the National Quality Forum (NQF). Proposals considered to incentivize all Medicare / Medicaid beneficiaries as well as all federal employees through FEHBP to create and store a digital AD. Senators Coburn and Coons have introduced legislation, the Medicare Choices Empowerment & Protection Act (S. 2240), to provide an incentive for Medicare beneficiaries to voluntarily adopt an AD, guiding the care they receive.

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

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

Discussion draft, to amend the Internal Revenue Code of 1986 to provide for comprehensive income tax reform (taxation of derivatives).Tax Reform Issues in general Renewable energy tax incentives in general. Issues related to tax rates in general H.R. 4196, To amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets S. 2240, A bill to amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets H.R. 3091, To make permanent the individual income tax rates for capital gains and dividends H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011, relating to inclusion of production tax credit H.R. 1465, S. 1030, Storage Technology for Renewable and Green Energy Act of 2013 S. 795, H.R. 1696, the Master Limited Partnerships Parity Act H.R.259, To amend the Internal Revenue Code of 1986 to terminate certain energy tax subsidies and lower the corporate income tax rate H.R. 1569, the New Fair Deal Busting Americas Rigid Outdated & Needless Subsidies Act of 2013, (tax incentives for electric vehicles and fueling infrastructure) S. 1225, the Solar Uniting Neighborhoods (SUN) Act of 2013 S. 2003, the Renewable Energy Parity Act of 2014 S. 2148, the Emergency Unemployment Compensation Extension Act of 2014 (pension smoothing) Expiring Provisions Improvement Reform and Efficiency (EXPIRE) Act, (energy tax extenders)

Client expense: $1,300,000 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Council on Environmental Quality (CEQ), Energy, Dept of, Environmental Protection Agency (EPA), Federal Energy Regulatory Commission (FERC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Natl Institute of Standards & Technology (NIST), Natl Park Service (NPS), Nuclear Regulatory Commission (NRC), Office of Management & Budget (OMB), SENATE, U.S. Fish & Wildlife Service (USFWS), White House Office

HR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; Device Tax Legislation.HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act. H.Con.Res. 25 S.Con. Res. Budget Resolutions S.886, S. 1013, H.R.845, H.R. 2024 Intellectual Property

Client expense: $730,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 2019 Gabriella Miller Kids First Research Act H.R. 1037 Occupational Therapy in Mental Health Act H.R. 1178 Creating Access to Residency Education Act of 2013H.R. 1180 Resident Physician Shortage Reduction Act of 2013 H.R. 1201 Training Tomorrow's Doctors Act H.R. 1252 Physical Therapist Workforce and Patient Access Act of 2013 H.R. 1274 Access to Quality Diabetes Education Act of 2013 H.R. 1326 Health Care Price Transparency Promotion Act of 2013 H.R. 1339 Palliative Care and Hospice Education and Training Act H.R. 1427 Truth in Healthcare Marketing Act of 2013 H.R. 1790 Health IT Modernization for Underserved Communities Act of 2013 H.R. 1814 Equitable Access to Care and Health (EACH) Act H.R. 1821 Registered Nurse Safe Staffing Act of 2013 H.R. 1827 Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 H.R. 1874 Pro-Growth Budgeting Act H.R. 1907 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013 H.R. 1976 Access to Certified Professional Midwives Act of 2013 H.R. 2131 Supplying Knowledge-based Immigrants and Lifting Levels of STEM (SKILLS) Visas Act of 2013 H.R. 235 Veteran Emergency Medical Technician Support Act of 2013 H.R. 2415 Treat and Reduce Obesity Act H.R. 244 Physician Availability Act of 2013 H.R. 2453 Medicare Beneficiary Preservation of Choice Act of 2013 H.R. 2484 Conrad State 30 and Physician Access Act H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 2651 Critical Care Assessment and Improvement Act of 2013 H.R. 2663 Preventive Health Savings Act H.R. 2801 Protecting Access to Rural Therapy Services (PARTS) Act H.R. 2810 Medicare Patient Access and Quality Improvement Act of 2013 H.R. 2843/S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 297 Children's Hospital GME Support Reauthorization Act of 2013 H.R. 2986 Protecting Access to Primary Care Act H.R. 3077 TELEmedicine for MEDicare Act of 2013 or TELE-MED Act of 2013 H.R. 3120 Comprehensive Dental Reform Act of 2013 H.R. 3303 Sensible Oversight for Technology which Advances Regulatory Efficiency (SOFTWARE) Act H.R. 3306 Telehealth Enhancement Act of 2013 H.R. 3362, Exchange Information Disclosure Act H.R. 3392 Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013 H.R. 3474 Hire More Heroes Act of 2013 H.R. 3507 21st Century Care for Military and Veterans Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3811, Health Exchange Security and Transparency Act H.R. 3979 Protecting Volunteer Firefighters and Emergency Responders Act of 2014 H.R. 4106, Barr-Bera Saving Lives, Saving Costs Act H.R. 4118, The SIMPLE Fairness Act H.R. 4160 - the "Keep the Promise to Seniors Act of 2014." H.R. 4177: a bill to amend the Internal Revenue Code of 1986 to Allow Medicare beneficiaries participating in a Medicare Advantage MSA to contribute their own money to their MSA. H.R. 4180: a bill to amend the Internal Revenue Code of 1986 to permit rollovers from health savings accounts to Medicare Advantage MSAs H.R. 4196: Seniors' Fairness Act of 2014H.R. 4201: Seniors' Rights to Know Act H.R. 487 Primary Care Workforce Access Improvement Act of 2013 H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.R. 7, No Taxpayer Funding for Abortion 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. 962 Medicare Diabetes Prevention Act H.R. 2575, the "Save American Workers Act of 2014," H.R. 4064, FAIR ACT of 2014 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.RES.356 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States. H.R.1024 The Medication Therapy Management Empowerment Act IMPACT Act of 2014 (Improving Medicare Post-Acute Care Transformation Act of 2014) S. 1060 Veterans to Paramedics Transition Act S. 1061 Veterans Access to Care Act S. 1064 Medicare Mental Health Access Act S. 1143 Protecting Access to Rural Therapy Services (PARTS) Act S. 1152 Building a Health Care Workforce for the Future Act S. 1184 Treat and Reduce Obesity Act S. 1193 Data Security and Breach Notification Act of 2013 S. 1228 Medicare Better Health Rewards Program Act S. 1422 Preventive Health Savings Act S. 1439 Care Planning Act of 2013 S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 1445 National Health Service Corps Improvement Act of 2013 S. 1475 National Nurse Act of 2013 S. 1517 Behavioral Health Information Technology Act of 2013 S. 1522 Comprehensive Dental Reform Act of 2013 S. 1557 Children's Hospital GME Support Reauthorization Act of 2013 S. 1685 Behavioral Health Information Technology Coordination Act of 2013 S. 1729 - Expanded Consumer Choice Act S. 1758 Quality Data, Quality Healthcare Act of 2013 S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013 S. 2000/H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2007, Preventing Regulatory Overreach To Enhance Care Technology Act of 2014 (PROTECT Act) S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2166 Treating Families Fairly Act S. 2168 amends the definition from 50 100 employees for the purposes of the employer mandate S. 2173 the CHOICE Act S. 2175 Enhancing Access to Agents and Brokers Act S. 2240 The Medicare Choices Empowerment and Protection Act S. 236 Medicare Patient Empowerment Act S. 328 Strengthening Rural Access to Emergency Services Act S. 382 A bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs.S. 452 Medicare Diabetes Prevention Act S. 557 The Medication Therapy Management Empowerment Act S. 577 The Resident Physician Shortage Reduction Act of 2013 S. 602 Physical Therapist Workforce and Patient Access Act of 2013 S. 616 Conrad State 30 and Physician Access Act S. 641 Palliative Care and Hospice Education and Training Act S. 739 National Nursing Shortage Reform and Patient Advocacy Act S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 945 Access to Quality Diabetes Education Act of 2013 S.1067 Innovation Inspiration School Grant Program Act S.1897 Personal Data Privacy and Security Act of 2014 S.1927 The Data Security Act of 2014 S.1932/H.R. 3890 The Better Care, Lower Cost Act S.1976 Data Security and Breach Notification Act of 2014 S.1995 Personal Data Protection and Breach Accountability Act S.2106, FAIR Act of 2014 S.236 / H.R. 1310 - Medicare Patient Empowerment Act of 2013 S.577 Resident Physician Shortage Reduction Act of 2013 S.RES.26 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

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

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

HR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; Device Tax Legislation.HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act. H.Con.Res. 25 S.Con. Res. Budget Resolutions S.886, S. 1013, H.R.845, H.R. 2024 Intellectual Property

Client expense: $690,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussion draft, to amend the Internal Revenue Code of 1986 to provide for comprehensive income tax reform (taxation of derivatives). Renewable energy tax incentives in general. Issues related to tax rates in general. Tax reform issues; general.H.R. 4196, To amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets S. 2240, A bill to amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets H.R. 3091, To make permanent the individual income tax rates for capital gains and dividends H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011, relating to inclusion of production tax credit H.Con. Res. 25, establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023 (tax reform) S.Con. Res. 8, an original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023, (tax reform) H.R. 1465, S. 1030, Storage Technology for Renewable and Green Energy Act of 2013 H.R. 1486, the No Carbon Tax Act of 2013 S. 795, H.R. 1696, the Master Limited Partnerships Parity Act H.R.259, To amend the Internal Revenue Code of 1986 to terminate certain energy tax subsidies and lower the corporate income tax rate

Client expense: $1,310,000 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Council on Environmental Quality (CEQ), Energy, Dept of, Environmental Protection Agency (EPA), Federal Energy Regulatory Commission (FERC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Natl Institute of Standards & Technology (NIST), Nuclear Regulatory Commission (NRC), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Fish & Wildlife Service (USFWS), White House Office

Discussion draft, to amend the Internal Revenue Code of 1986 to provide for comprehensive income tax reform (taxation of derivatives). Renewable energy tax incentives in general. Issues related to tax rates in general. Tax reform issues; general.H.R. 4196, To amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets S. 2240, A bill to amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets H.R. 3091, To make permanent the individual income tax rates for capital gains and dividends H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011, relating to inclusion of production tax credit H.Con. Res. 24, expressing the sense of Congress that a carbon tax would be detrimental to the U.S. economy H.Con. Res. 25, establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023 (tax reform) S.Con. Res. 8, an original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023, (tax reform) H.R. 1465, S. 1030, Storage Technology for Renewable and Green Energy Act of 2013 H.R. 1486, the No Carbon Tax Act of 2013 S. 795, H.R. 1696, the Master Limited Partnerships Parity Act H.R.259, To amend the Internal Revenue Code of 1986 to terminate certain energy tax subsidies and lower the corporate income tax rate

Client expense: $950,000 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Commerce, Dept of (DOC), Council on Environmental Quality (CEQ), Energy, Dept of, Environmental Protection Agency (EPA), Federal Energy Regulatory Commission (FERC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Natl Institute of Standards & Technology (NIST), Nuclear Regulatory Commission (NRC), SENATE, State, Dept of (DOS), U.S. Fish & Wildlife Service (USFWS), White House Office

Corporate Alternative Minimum Tax Credits (H.R. 4196, S. 2240)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

General automotive industry issues and issues relating to GM restructuring; (H.R. 4196, S.2240, S.3521)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

HR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; Device Tax Legislation.HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act. H.Con.Res. 25 S.Con. Res. Budget Resolutions S.886, S. 1013, H.R.845, H.R. 2024 Intellectual Property

Client expense: $720,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; S. 232 Device Tax Legislation. Device Tax Legislation.HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act. H.Con.Res. 25 S.Con. Res. Budget Resolutions S.886, S. 1013, H.R.845, H.R. 2024 Intellectual Property

Client expense: $1,111,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussion draft, to amend the Internal Revenue Code of 1986 to provide for comprehensive income tax reform (taxation of derivatives). Renewable energy tax incentives in general. Issues related to tax rates in general. Tax reform issues; general.H.R. 4196, To amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets. S. 2240, A bill to amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets. H.R. 3091, To make permanent the individual income tax rates for capital gains and dividends. H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011, relating to inclusion of production tax credit. H.Con. Res. 24, expressing the sense of Congress that a carbon tax would be detrimental to the U.S. economy. H.Con. Res. 25, establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023 (tax reform). S.Con. Res. 8, an original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023, (tax reform). H.R. 1465, S. 1030, Storage Technology for Renewable and Green Energy Act of 2013 H.R. 1486, the No Carbon Tax Act of 2013 S. 795, the Master Limited Partnerships Parity Act

Client expense: $850,000 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Federal Energy Regulatory Commission (FERC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Natl Institute of Standards & Technology (NIST), Nuclear Regulatory Commission (NRC), SENATE, State, Dept of (DOS), U.S. Fish & Wildlife Service (USFWS), White House Office

Discussion draft, to amend the Internal Revenue Code of 1986 to provide for comprehensive income tax reform (taxation of derivatives). Renewable energy tax incentives in general. Issues related to tax rates in general. Tax reform issues; general.H.R. 4196, To amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets. S. 2240, A bill to amend the Internal Revenue Code of 1986 to extend the allowance for bonus depreciation for certain business assets. H.R. 3091, To make permanent the individual income tax rates for capital gains and dividends. H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011, relating to inclusion of production tax credit. H.R. 8, the American Taxpayer Relief Act of 2012" H. Con. Res. 24, expressing the sense of Congress that a carbon tax would be detrimental to the United States economy. H. Con. Res. 25, establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023, (tax reform). S. Con. Res. 8, an original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023, (tax reform).

Client expense: $840,000 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Federal Energy Regulatory Commission (FERC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Nuclear Regulatory Commission (NRC), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Fish & Wildlife Service (USFWS), White House Office

Tax incentives for electric vehicles and charging stations, IRC sections 30(c) and 30(d); Corporate Alternative Minimum Tax Credits including HR3123, HR4196, S 2240.

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

Government targets: Executive Office of the President (EOP), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, SENATE

General automotive industry issues and issues relating to GM restructuring; (h.R. 4196, S.2240, S.3521)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Corporate Alternative Minimum Tax Credits (H.R. 4196, S. 2240)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General automotive industry issues and issues relating to GM restructuring; (h.R. 4196, S.2240, S.3521)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Corporate Alternative Minimum Tax Credits (H.R. 4196, S. 2240)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2672/S. 1423, the Preserving Access to Orphan Drugs Act of 2011: Amends the Patient Protection and Affordable Care Act (PPACA) to exclude any drug or biological product which is approved or licensed by the Food and Drug Administration (FDA) for marketing solely for one or more rare diseases or conditions from the annual fee on manufacturers or importers with branded prescription drug sales exceeding $5 million.Device Tax LegislationHR4213 -The tax Extenders Act of 2009; HR5297; The Small Business Jobs and Credit Act and HR 4853: The tax relief, unemployment Insurance Reauthorization and job Creation Act of 2010, as they related to the R&D tax credit ; Device Tax Legislation HR 3630, Middle Class Tax Relief and Job Creation Act (this is the payroll tax relief extension bill) S. 1813, MAP-21 Act (the Senate highway bill with pension relief) HR 4196 and S.2240, extension of bonus depreciation S.2240/HR 4196, to extend bonus depreciation; and S. 2237, the Small Business Jobs and Tax Relief Act, as it relates to bonus depreciation. S. 1813/HR 4348, MAP-21, as it relates to pension funding relief. Issues related to the R&D tax credit, the taxation of U.S. multinational corporations and corporate tax reform. S. 3521, The Family and Business Tax Cut Certainty Act of 2012, HR 8, the American Taxpayer Relief Act.

Client expense: $660,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Greater Research Opportunities with Tax Help Act (S. 1577) and American Research and Competitiveness Act, 2011 (H.R. 942), all provisions; To amend the Internal Revenue Code of 1986 to extend the allowance for certain business assets (S. 2240 and H.R. 4196); the Small Business Jobs and Tax Relief Act (S. 2237), provisions relating to bonus depreciation; the Mobile Workforce State Income Tax Simplification Act of 2012, all provisions. American Taxpayer Relief Act of 2012(H.R. 8), provisions (continues)related to business tax extenders. Issues pertaining to comprehensive tax reform.

Client expense: $1,610,000 · Firm income: Not reported

Government targets: Central Intelligence Agency (CIA), Commerce, Dept of (DOC), Defense Intelligence Agency (DIA), Defense Security Cooperation Agency (DSCA), Defense, Dept of (DOD), Export-Import Bank of the United States (EXIM Bank), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Aeronautics & Space Administration (NASA), Natl Geospatial Intelligence Agency, Natl Oceanic & Atmospheric Administration (NOAA), Natl Security Agency (NSA), SENATE, State, Dept of (DOS), Treasury, Dept of