Medicare Diabetes Prevention Act of 2013

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Labor, HHS Appropriations bill, 2015-Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R.3850/S. 1562, Discussed Older Americans Act reauthorization legislation. H.R.3662, the Mental Health Access Improvement Act - Sent letter of endorsement. H.R.4879, the Research for All Act - Sent letter of endorsement. S.2348, the Removing Barriers to Colorectal Cancer Screening Act - Sent letter of endorsement. Discussed legislation to address health disparities. (no bill) H.R.5294 - Discussed Health Equity & Accountability Act of 2014; no endorsement due to budget implications. H.R. 83, Consolidated and Further Continuing Appropriations, 2015 - Lobbied to protect various healthcare programs serving seniors from disproportionate reduction.Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. Discussed H.R. 3717, the Helping Families in Mental Health Crisis Act. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed the Convention on the Rights of Persons with Disabilities. (no bill) H.R. 2835/S. 1647, Restoring Access to Medication Act of 2013 - Urged co-sponsorship of these bills. Discussed hospital readmissions. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H. R. 3850 - Discussed Older Americans Act reauthorization legislation. H.R. 5183, Better Care Act - Discussed legislation with staff regarding the bill. H.R. 5232, Notice of Observation Treatment & Implication for Care Eligibility (Notice Act) - Discussed legislation with staff. Discussed oral health and older adulsts. (no bill)

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

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

S. 452/H.R. 962, the Medicare Diabetes Prevention Act. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. H.R. 2663/S. 1422, the Preventive Health Savings Act. H.R. 5294, the Health Equity and Accountability Act. S. 2210/H.R. 1783, the School Food Modernization Act.S. 452/H.R. 962, the Medicare Diabetes Prevention Act. Support entire bill; provides for Medicare coverage of National Diabetes Prevention Program. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. Support entire bill; provides funding for the establishment of a tracking and surveillance system at the CDC and provides grant funding for public health research on gestational diabetes. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. Support entire bill; requires states to report on and reach physical education benchmarks; and requires training of physical education teachers and school administrators; physical education curriculum; and dedicated school space for physical education and physical activity. H.R. 2663/S. 1422, the Preventive Health Savings Act. Support entire bill; requires the Director of the Congressional Budget Office, upon a request by the chairman or ranking minority member of certain congressional committees, to determine if proposed legislation would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services. H.R. 5294, the Health Equity and Accountability Act. Support provisions addressing diabetes, including the Eliminating Disparities in Diabetes Prevention, Access and Care Act (sections 771-775) and the Gestational Diabetes Act (section 509). S. 2210/H.R. 1783, the School Food Modernization Act. Support entire bill; provides loans to schools to update kitchen equipment in order to prepare healthy foods for students. Issues worked on not yet reflected in legislation: The Physician Payments Sunshine Act (also called the Open Payments Program) of the Affordable Care Act. Requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The Association would like to see the Centers for Medicare and Medicaid Services make an Open Payments Program reporting exemption for indirect payments made to voluntary health agencies (VHAs) in cases when an applicable manufacturer grants full and independent discretion to VHAs in selecting recipients for funding. 21st Century Cures Initiative. The initiative was convened by the House Energy and Commerce Committee to address ways to improve medical research and development and delivery of innovative new treatments and cures. The Committee is developing legislation and the Association is particularly interested in any provisions that may relate to medical research. Surgeon General of the United States: Support the confirmation of Dr. Vivek Murthy for the post of Surgeon General of the United States. Support Draft Recommendation for Screening for Type 2 diabetes released by the United States Preventive Services Task Force. The draft recommendation suggests screening for type 2 diabetes in adults with multiple risk factors.

Client expense: $128,000 · Firm income: Not reported

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

- Issues related to ensuring quality of supply chain for FDA regulated products. - Issues related to Accountable Care Organizations. - PL 111-148, "Patient Protection and Affordable Care Act", issues related to Physician Payment Sunshine provisions. - Issues related to regulation and reimbursement of diagnostics.- Issues related to health care reform, regarding Medicare wellness benefit. - Issues related to maintaining the biosimilars statute without changes. - HR 1074, "National Diabetes Clinical Care Commission Act", regarding all provisions. - S 539, "National Diabetes Clinical Care Commission Act", regarding all provisions. - S 452, "Medicare Diabetes Prevention Act of 2013", regarding all provisions. - Issues related to personalized medicine incentives and regulation. - Issues related to Moddern Cures initiative. - Issues related to modernizing laboratory test standards. - Issues related to diagnostic payments. - PL 111-148, "Patient Protection and Affordable Care Act", issues related to vision care coverage. - PL 112-144, "Food and Drug Administration Safety and Innovation Act", regarding Medical Device User Fee Act provisions. - Issues related to the repeal and/or reform of Independent Payment Advisory Boards. - Issues related to hepatitis C testing and treatment guidelines. - PL 101-381, "Ryan White Comprehensive AIDS Resources Emergency (CARE) Act" and issues related to state ADAP funding. - Issues related to drug resistant tuberculosis. - Issues related to legislation that would establish drug importation. - Issues related to legislation that would establish a rebate in the Medicare Part D program. - Issues related to legislation that would modify the Medicare Part B drug reimbursement program. - Issues related to medical device reprocessing. - Issues related to health care pricing transparency. - HR 3303, "Mobile Medical Application", regarding all provisions. - Issues related to health care associated inflation policy. - HR 2663/ S 1422, "Preventative Health Savings Act", regarding all provisions. - HR 3204, "Drug Quality and Security Act", regarding all provisions. - Issues related to neglected tropical diseases. - Issues related to transferable market exclusivity. - Issues related to health care associated infections. - S 959, "Pharmaceutical Quality Security and Accountability Act", regarding all provisions. - Issues related to FDA regulation of custom medical devices. - Issues related to Tricare coverage of Total Disc Arthroplasty. - Issues related to VA requirements for vendor access and credentialing. - Issues related to 21st Century Cures. - Issues related to Medicare beneficiary access. - Issues related to mobile medical applications and digital healthcare. - Issues related to FDA draft guidances on blood glucose meters. - HR 4895/ S 2902, "The Microbead Free Waters Act of 2014", regarding all provisions. - Issues related to the expanded use of unapproved drugs. - Issues related to combination products. - Issues related to the PROTECT Act (bill number pending), specifically medical mobile applications. - Issues related to Government Health Care Exclusion/ Debarment (bill number pending) - S 2977, "MEDTECH Act", regarding provisions related to medical mobile applications. - S 2917, "Adding Ebola to the FDA Priority Review Voucher Program Act", regarding all provisions.

Client expense: $1,400,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 In all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 - Medicare Diabetes Prevention Act of 2013 HR 1257 Prevent Diabetes Medicare Act of 2013 HR 1274/S 945 Access to Quality Diabetes Education Act of 2013; HR 1588/ S 740 -- Medicare Drug Savings Act of 2013 HR 2415/ S 1184 - Treat and Reduce Obesity Act of 2013; HR 2663/S 1422 - Scoring of Preventive Health Savings Medicare diabetes screening and self management

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 In all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 Medicare Diabetes Prevention Act of 2013; HR 1257 - Prevent Diabetes in Medicare Act of 2013; HR 1247/S 945 - Access to Quality Diabetes Education Act of 2013; HR 2663/ S 1422 Scoring of Preventive Health Savings; and S 1284 - Department of Labor, Health and Human Services and Education and Related Agencies Appropriations Act of 2014, specifically NDPP funding HR 83 - Consolidated and Further Continuing Appropriations Act, 2015

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 962 and S. 452, the Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in Pub. L. 112-25, the Budget Control Act of 2011 and H.R. 8, the American Taxpayer Relief Act of 2012; H.R. 1588 and S. 740, the Medicare Drug Savings Act of 2013; H.R. 1257, the Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S. 945, the Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare); Medicare diabetes screening generally; diabetes screening recommendations under USPSTF.

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

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

Issues related to Medicare Part D and Medicaid rebates; H.R.962/S. 452, Medicare Diabetes Prevention Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Actof 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally; S. 1184 and H.R. 2415 Treat and Reduce Obesity Act of 2013 and obesity medication coverage generally; Diabesity amendment to S. 1871 SGR Repeal and Medicare Beneficiary Access; Physician Quality and Reporting System (PQRS)

Client expense: $280,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

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

Client expense: $19,160 · Firm income: Not reported

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

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

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

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

Issues related to Medicare Part D and Medicaid rebates; H.R.962/S. 452, Medicare Diabetes Prevention Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Implementation of P.L. 111-148, The Patient Protection and Affordable Care Act; Title III- Improving the Quality and Efficiency of Health Care; S. 452/H.R. 962, The Medicare Diabetes Prevention Act of 2013; S. 351/H.R. 351, Protecting Seniors Access to Medicare Act of 2013; H.R. 241/S. 1184. Treat and Reduce Obesity Act- All provisions; H.R. 2663, To Amend the Congressional Budget Act Respecting Scoring of Prevention Health Savings- All Provisions; H.R. 4015/S.2000, The SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions.

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

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

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Act of 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally; S. 1184 and H.R. 2415 Treat and Reduce Obesity Act of 2013; Physician Quality and Reporting System (PQRS). Diabesity amendment to S. 1871 SGR Repeal and Medicare Beneficiary Access.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Labor, HHS Appropriations bill, 2015-Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R.3850/S. 1562, Discussed Older Americans Act reauthorization legislation. H.R.3662, the Mental Health Access Improvement Act - Sent letter of endorsement. H.R.4879, the Research for All Act - Sent letter of endorsement. S.2348, the Removing Barriers to Colorectal Cancer Screening Act - Sent letter of endorsement. Discussed legislation to address health disparities. (no bill) H.R.5294 - Discussed Health Equity & Accountability Act of 2014; no endorsement due to budget implications. H.J. Res. 124, Continuing Appropriations Resolution, 2015 - Lobbied to protect various healthcare programs serving seniors from disproportionate reduction under Continuing Resolution.Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. Discussed H.R. 3717, the Helping Families in Mental Health Crisis Act. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed the Convention on the Rights of Persons with Disabilities. (no bill) H.R. 2835/S. 1647, Restoring Access to Medication Act of 2013 - Urged co-sponsorship of these bills. Discussed hospital readmissions. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H. R. 3850 - Discussed Older Americans Act reauthorization legislation. H.R. 5183, Better Care Act - Discussed legislation with staff regarding the bill. H.R. 5232, Notice of Observation Treatment & Implication for Care Eligibility (Notice Act) - Discussed legislation with staff.

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

- Issues related to ensuring quality of supply chain for FDA regulated products. - Issues related to Accountable Care Organizations. - PL 111-148, "Patient Protection and Affordable Care Act", issues related to Physician Payment Sunshine provisions. - Issues related to regulation and reimbursement of diagnostics.- Issues related to health care reform, regarding Medicare wellness benefit. - Issues related to maintaining the biosimilars statute without changes. - HR 1074, "National Diabetes Clinical Care Commission Act", regarding all provisions. - S 539, "National Diabetes Clinical Care Commission Act", regarding all provisions. - S 452, "Medicare Diabetes Prevention Act of 2013", regarding all provisions. - Issues related to personalized medicine incentives and regulation. - Issues related to Moddern Cures initiative. - Issues related to modernizing laboratory test standards. - Issues related to diagnostic payments. - PL 111-148, "Patient Protection and Affordable Care Act", issues related to vision care coverage. - PL 112-144, "Food and Drug Administration Safety and Innovation Act", regarding Medical Device User Fee Act provisions. - Issues related to the repeal and/or reform of Independent Payment Advisory Boards. - Issues related to hepatitis C testing and treatment guidelines. - PL 101-381, "Ryan White Comprehensive AIDS Resources Emergency (CARE) Act" and issues related to state ADAP funding. - Issues related to drug resistant tuberculosis. - Issues related to legislation that would establish drug importation. - Issues related to legislation that would establish a rebate in the Medicare Part D program. - Issues related to legislation that would modify the Medicare Part B drug reimbursement program. - Issues related to medical device reprocessing. - Issues related to health care pricing transparency. - HR 3303, "Mobile Medical Application", regarding all provisions. - Issues related to health care associated inflation policy. - HR 2663/ S 1422, "Preventative Health Savings Act", regarding all provisions. - HR 3204, "Drug Quality and Security Act", regarding all provisions. - Issues related to neglected tropical diseases. - Issues related to transferable market exclusivity. - Issues related to health care associated infections. - S 959, "Pharmaceutical Quality Security and Accountability Act", regarding all provisions. - Issues related to FDA regulation of custom medical devices. - Issues related to Tricare coverage of Total Disc Arthroplasty. - Issues related to VA requirements for vendor access and credentialing. - Issues related to 21st Century Cures. - Issues related to Medicare beneficiary access. - Issues related to mobile medical applications and digital healthcare. - Issues related to FDA draft guidances on blood glucose meters. - HR 4895/ S 2902, "The Microbead Free Waters Act of 2014", regarding all provisions. - Issues related to the expanded use of unapproved drugs. - Issues related to combination products. - Issues related to the PROTECT Act (bill number pending), specifically medical mobile applications. - Issues related to Government Health Care Exclusion/ Debarment (bill number pending)

Client expense: $1,350,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 H Con Res 96 Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024/no Senate companion yet HJ Res 124 Continuing Appropriations Resolution, 2015 In all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 Medicare Diabetes Prevention Act of 2013; HR 1257 - Prevent Diabetes in Medicare Act of 2013; HR 1247/S 945 - Access to Quality Diabetes Education Act of 2013; HR 2663/ S 1422 Scoring of Preventive Health Savings; and S 1284 - Department of Labor, Health and Human Services and Education and Related Agencies Appropriations Act of 2014, specifically NDPP funding

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 H Con Res 96 Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024/no Senate companion yet, HJ Res 124 Continuing Appropriations Resolution, 2015 In all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 - Medicare Diabetes Prevention Act of 2013 HR 1257 Prevent Diabetes Medicare Act of 2013 HR 1274/S 945 Access to Quality Diabetes Education Act of 2013; HR 1588/ S 740 -- Medicare Drug Savings Act of 2013 HR 2415/ S 1184 - Treat and Reduce Obesity Act of 2013; HR 2663/S 1422 - Scoring of Preventive Health Savings Medicare diabetes screening and self management

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 962 and S. 452, the Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in Pub. L. 112-25, the Budget Control Act of 2011 and H.R. 8, the American Taxpayer Relief Act of 2012; H.R. 1588 and S. 740, the Medicare Drug Savings Act of 2013; H.R. 1257, the Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S. 945, the Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare); Medicare diabetes screening generally; diabetes screening recommendations under USPSTF.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1179, Improving Access to Medicare Coverage Act of 2013, all provisions S. 569, Improving Access to Medicare Coverage Act of 2013, all provisions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisionsH.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisions H.R. 962, Medicare Diabetes Prevention Act of 2013, all provisions S. 452, Medicare Diabetes Prevention Act of 2013, all provisions H.R. 4302, Protecting Access to Medicare Act of 2014, provisions relating to Physician Payment Reform/SGR Repeal S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, all provisions S. 2694, Ensuring Access to Primary Care for Women & Children Act, all provisions S. 2552, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 3698, Two-Midnight Rule Delay Act of 2013, all provisions H.R. 4282, Creating Access to Residency Education Act of 2014, all provisions H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes, all provisions Medicare program: Protecting Integrity in Medicare Act (PIMA) of 2014 Medicare program: Stop Scams Act Medicare program: Medicare Advantage Medicare program: Medicare Part D Medicare program: Medicare claims data release Medicare program: SGR Repeal Medicare program: Graduate Medical Education Medicare program: Sunshine Act (Open Payments Program) Notice of a New System of Records Medicare program: Electronic Health Records Meaningful Use Regulations/program flexibility Medicare program: ICD-10 Repeal Medicare program: CPT Medicare program: HIPAA Medicare program: RUC - Misvalued and Care Coordination Codes Medicare program: Local Coverage Determinations Medicare program: Physician payment and delivery reform Medicare program: Physician Compare Medicare program: Telemedicine and Medicare payment policy Medicare program: Practice Transformation Medicare program: In-Office Ancillary Services Exception Medicare program: Independent Payment Advisory Board (IPAB) Repeal Medicare program: Private Contracting Medicare program: New payment models/measuring quality performance Medicare program: Hospital short-stay issue Medicare program: Physician Consortium for Performance Improvement (PCPI) Medicare program: Recovery Audit Contractors Medicare program: Program Integrity Medicare program: Home health Medicare program: Funding for quality measure development Medicare program: Payment neutrality/hospital inpatient and outpatient sites Medicare program: Value-Based Modifier and Quality Resource Use Reports Medicare program: Laboratory Developed Tests - coding, coverage and payment Medicaid program: Medicaid expansion

Client expense: $4,230,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Actof 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally; S. 1184 and H.R. 2415 Treat and Reduce Obesity Act of 2013 and obesity medication coverage generally; Diabesity amendment to S. 1871 SGR Repeal and Medicare Beneficiary Access; Physician Quality and Reporting System (PQRS)

Client expense: $910,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Act of 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Better Care, Lower Cost Act (Wyden) (S.1932) Medication Adherence Medicare Access to Rehabilitation Services Act (H.R. 713/S.367) Medicare Diabetes Prevention Act (S. 452)Medicare SGR Reform (Senate Finance draft, House Ways & Means draft) Medicare SGR Repeal & Beneficiary Access Improvement Act (S.2110) Medication Therapy Management Act of 2013 (H.R. 1024/S.557) Pathway for SGR Reform Act (temporary extension of Medicare extenders) (H.J. Res.59) Protecting Access to Medicare Act (H.R.4302) Recruiting Individuals to Drive our Elders (RIDE) Act-not yet introduced SGR Repeal and Medicare Beneficiary Access Act (S.1871& H.R.2810)

Client expense: $205,194 · Firm income: Not reported

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

Issues related to Medicare Part D and Medicaid rebates; H.R.962/S. 452, Medicare Diabetes Prevention Act of 2013; "Diabesity" amendment to S. 1871, SGR Repeal and Medicare Beneficiary Access.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 452/H.R. 962, the Medicare Diabetes Prevention Act., H.R. 1915/S. 907, the Gestational Diabetes Act of 2013, H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act, H.R. 2343, the Healthy Food Financing Initiative, H.R. 2663/S. 1422, the Preventive Health Savings Act, H.R. 3322, Eliminating Disparities in Diabetes Prevention, H.R. 3591, Minority Diabetes Initiative Act, S. 1932, Better Care, Lower Cost Act. ( See next page for details).S. 452/H.R. 962, the Medicare Diabetes Prevention Act. Support entire bill providing for Medicare Coverage of National Diabetes Prevention Program. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. Support entire bill; provides funding for the establishment of a tracking and surveillance system at the Centers for Disease Control and Prevention and provides grant funding for public health research on gestational diabetes. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. Support entire bill; requires states to report on and reach physical education benchmarks; and requires training of physical education teachers and school administrators; physical education curriculum; and dedicated school space for physical education and physical activity. H.R. 2343, the Healthy Food Financing Initiative. Support entire bill; to provide financing to expand or improve supermarkets, grocery stores and other retail food options in underserved areas in order to make healthier food options available. H.R. 2663/S. 1422, the Preventive Health Savings Act. Support entire bill; to require the Director of the Congressional Budget Office (CBO), upon a request by the chairman or ranking minority member of certain congressional committees, to determine if proposed legislation would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services. H.R. 3322, Eliminating Disparities in Diabetes Prevention, Access and Care Act. Support entire bill; expands resources at NIH, CDC, HRSA, and IHS to promote research, treatment, and education regarding diabetes in minority populations. H.R. 3591, Minority Diabetes Initiative Act. Support entire bill; provides grants for improved diabetes care for minority populations. S. 1932, Better Care, Lower Cost Act. Support part of bill; establishes a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions, and for other purposes. Issues worked on the Hill not yet reflected in legislation: United States Preventive Services Task Forcesupport any efforts to require the USPSTF to update its recommendation for diabetes screening including gestational diabetes screening based on new evidence.

Client expense: $138,000 · Firm income: Not reported

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

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Labor, HHS Appropriations bill, 2015-Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed Care Corps. (no bill) Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R.3850/S. 1562, Discussed Older Americans Act reauthorization legislation.Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. S. Con. Res. 8/ H.Con. Res. 25, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. H.R. 1549, Helping Sick Americans Now Act - Discussed cuts to the health care prevention fund. The Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. Discussed H.R. 3717, the Helping Families in Mental Health Crisis Act. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed National Alzheimer's Project Act 111-375. Discussed the Convention on the Rights of Persons with Disabilities. (no bill) Discussed family caregiving, doctors and health professionals engaging family caregivers of older adults with multiple chronic conditions, family caregiver assessment, shared relevant information. (no bill) H.R. 2835/S. 1647, Restoring Access to Medication Act of 2013 - Urged co-sponsorship of these bills. Submitted statement for the record to the Advisory Counsel on Alzheimer's Disease, Research, Care & Services for their April meeting. Discussed hospital readmissions. (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

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Act of 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally; S. 1184 and H.R. 2415 Treat and Reduce Obesity Act of 2013; Physician Quality and Reporting System (PQRS). Diabesity amendment to S. 1871 SGR Repeal and Medicare Beneficiary Access.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Implementation of P.L. 111-148, The Patient Protection and Affordable Care Act; Title III - Improving the Quality and Efficiency of Health Care; S. 452/H.R. 962, The Medicare Diabetes Prevention Act of 2013; S. 351/H.R. 351, Protecting Senior's Access to Medicare Act of 2013; H.R. 2415/S. 1184. Treat and Reduce Obesity Act- All Provisions; H.R. 2663, To Amend the Congressional Budget Act Respecting Scoring of Prevention Health Savings - All Provisions; H.R. 4015/S.2000, The SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions.

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

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

Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Middle Class Tax Relief and Job Promotion Act (H.R. 3630) 3.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 4.Implementation of Pandemic and All-Hazards Preparedness Act (Public Law 109-417) 5.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 6.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 7.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 8.Animal Drug and Animal Generic Drug User Fee Act (S. 622/H.R.___) 9.Healthier Lifestyles and Prevention America Act (S. 39) 10.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392) 11.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 12.Personal Health Investment Today Act (H.R. 956) 13.A bill to provide for a sequester replacement (S. 16) 14.American Family Economic Protection Act of 2013 (S. 388) 15.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933) 16.Regulations From the Executive in Need of Scrutiny Act of 2013 (S. 15 / H.R. 367) 17.To repeal the Prevention and Public Health Fund (H.R. 1099) 18.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 19.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 20.Physical Activity Guidelines for Americans Act (S. 531) 21.Firearm Safety and Public Health Research Act (H.R. 321) 22.Helping Sick Americans Now Act (H.R. 1549) 23.Energy Consumers Relief Act (H.R. 1582) 24.Common Sense Nutrition Disclosure Act (H.R. 1249) 25.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 26.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 27.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 28.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 29.FIT Kids Act (S. 1033/H.R. 2178) 30.Strengthening Americas Schools Act (S. 840) 31.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 32.Fit to Serve Act (S. 976) 33.Climate Change Health Protection and Promotion Act (H.R. 2023) 34.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 35.Student Success Act (H.R. 5) 36.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 37.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 38.Senate FY14 Labor, Health and Human Services, and Education Bill 39.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 40.Pharmacy Compounding Quality and Accountability Act (S. 959) 41.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 42.Drug Supply Chain Security Act (S. 957) 43.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 44.Healthy Families Act (H.R. 1286/S. 631) 45.FY2014 Continuing Resolution (H.J. Res. 59) 46.Drug Quality and Security Act (H.R. 3204) 47.Pharmaceutical Quality, Security and Accountability Act (S. 959) 48.Energy Consumers Relief Act (H.R. 1582) 49.Increasing the Safety of Prescription Drug User Act (not yet introduced proposed by Sen. Udall-NM) 50.National Energy Tax Repeal Act (S. 1324)51.Saving Coal Jobs Act of 2013 (S. 1514) 52.Community Parks Revitalization Act (H.R. 2424) 53.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 54.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 55.Nutrition Reform and Work Opportunity Act (H.R. 3102) 56.Health Equity and Accountability Act (not yet introduced) 57.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 58.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 59.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 60.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 61.The Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102) 62.Better Care, Lower Cost Act (S. 1932/H.R. 3890) 63.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 64.Preventing Antibiotic Resistance Act (S. 1256) 65.The Consolidated Appropriations Act of 2014 66.Strategies to Address Antimicrobial Resistance (STAAR) Act 67.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 68.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 69.Electricity Security and Affordability Act (HR 3826) 70.Stop Overdose Stat Act (HR 4169) and Senate companion bill soon to be introduced by Senator Reed 71.Opioid Overdose Reduction Act (S. 2092/H.R. 4288) 72.Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2014 (DISARM Act) (H.R. 4186) 73.Child Care and Development Block Grant Act of 2014 (S. 1086) 74.Departments of Labor, Health and Human Services and Education And Related Agencies Fiscal Year 2015 Appropriations Bill 75.Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2015 (S. 2389 / H.R. 4800) 76.Department of the Interior, Environment, and Related Agencies appropriations legislation, 2015 77.MAP-21 Reauthorization Act (S. 2322) 78.Stop Subsidizing Childhood Obesity Act (S. 2342/H.R. 2831) 79.ENRICH Act (H.R. 4427) 80.Agricultural Act of 2014 (Public Law 113-79) 81.Healthy Kids Outdoors Act of 2014 (S. 2367/H.R. 4706) 82.A bill to amend the Richard B. Russell National School Lunch Act to improve the efficiency of summer meals (S. 2527) 83.Summer Meals Act of 2014 (HR. 5012) 84.Long-Term SCORE Act (H.R. 4444) 85.American Cures Act (S. 2115/H.R. 4384) 86.A joint resolution to disapprove a rule of the Environmental Protection Agency relating to greenhouse gas emissions from electric utility generating units. (S.J. Res 30) 87.Fit for Life Act of 2014 (H.R.4765) 88.School Food Modernization Act (S. 2210/H.R. 1783) 89.Protecting Children from Electronic Cigarette Advertising Act of 2014 (S. 2014/H.R. 4325) 90.Pedestrian Safety Act of 2014 (S. 2284) 91.Safe Streets Act of 2014 (S. 2004/H.R. 2468) 92.The Recovery Enhancement for Addiction Treatment Act (not yet introduced, by Senator Markey) 93.FY 2015 Financial Services and General Government Appropriations bill, in support of an appropriation for the National Alliance for Model State Drug Laws

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

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

- Issues related to ensuring quality of supply chain for FDA regulated products. - Issues related to Accountable Care Organizations. - PL 111-148, "Patient Protection and Affordable Care Act", issues related to Physician Payment Sunshine provisions. - Issues related to regulation and reimbursement of diagnostics.- Issues related to health care reform, regarding Medicare wellness benefit. - Issues related to maintaining the biosimilars statute without changes. - HR 1074, "National Diabetes Clinical Care Commission Act", regarding all provisions. - S 539, "National Diabetes Clinical Care Commission Act", regarding all provisions. - S 452, "Medicare Diabetes Prevention Act of 2013", regarding all provisions. - Issues related to personalized medicine incentives and regulation. - Issues related to Moddern Cures initiative. - Issues related to modernizing laboratory test standards. - Issues related to diagnostic payments. - PL 111-148, "Patient Protection and Affordable Care Act", issues related to vision care coverage. - PL 112-144, "Food and Drug Administration Safety and Innovation Act", regarding Medical Device User Fee Act provisions. - Issues related to the repeal and/or reform of Independent Payment Advisory Boards. - Issues related to hepatitis C testing and treatment guidelines. - PL 101-381, "Ryan White Comprehensive AIDS Resources Emergency (CARE) Act" and issues related to state ADAP funding. - Issues related to drug resistant tuberculosis. - Issues related to legislation that would establish drug importation. - Issues related to legislation that would establish a rebate in the Medicare Part D program. - Issues related to legislation that would modify the Medicare Part B drug reimbursement program. - Issues related to medical device reprocessing. - Issues related to health care pricing transparency. - HR 3303, "Mobile Medical Application", regarding all provisions. - HR 2085, "Diagnostic Payment Reform", regarding all provisions. - Issues related to health care associated inflation policy. - HR 2663/ S 1422, "Preventative Health Savings Act", regarding all provisions. - HR 3204, "Drug Quality and Security Act", regarding all provisions. - Issues related to neglected tropical diseases. - Issues related to transferable market exclusivity. - HR 4015, "SGR Repeal and Medicare Provider Payment Modernization Act of 2014", regarding all provisions. - Issues related to health care associated infections. - S 959, "Pharmaceutical Quality Security and Accountability Act", regarding all provisions. - Issues related to FDA regulation of custom medical devices. - Issues related to Tricare coverage of Total Disc Arthroplasty. - Issues related to VA requirements for vendor access and credentialing. - Issues related to 21st Century Cures. - Issues related to Medicare beneficiary access. - Issues related to mobile medical applications and digital healthcare. - Issues related to FDA draft guidances on blood glucose meters. - HR 4895, "The Microbead Free Waters Act of 2014", regarding all provisions. - Issues related to the expanded use of unapproved drugs.

Client expense: $1,060,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 H Con Res 96 Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024/no Senate companion yet In all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 Medicare Diabetes Prevention Act of 2013; HR 1257 - Prevent Diabetes in Medicare Act of 2013; HR 1247/S 945 - Access to Quality Diabetes Education Act of 2013; HR 2663/ S 1422 Scoring of Preventive Health Savings; and S 1284 - Department of Labor, Health and Human Services and Education and Related Agencies Appropriations Act of 2014, specifically NDPP funding

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 H Con Res 96 Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024/no Senate companion yetIn all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 - Medicare Diabetes Prevention Act of 2013 HR 1257 Prevent Diabetes Medicare Act of 2013 HR 1274/S 945 Access to Quality Diabetes Education Act of 2013; HR 1588/ S 740 -- Medicare Drug Savings Act of 2013 HR 2415/ S 1184 - Treat and Reduce Obesity Act of 2013; HR 2663/S 1422 - Scoring of Preventive Health Savings Medicare diabetes screening and self management

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 855, the Optometric Equity in Medicaid Act, all provisions. HR 920, To amend the Public Health Service Act to provide for the participation of optometrists in the National Health Service Corps scholarship and loan repayment programs, and for other purposesHR 962, Medicare Diabetes Prevention Act of 2013, all sections relating to vision. HR 1074, National Diabetes Clinical Care Commission Act, all sections relating to vision. HR 1257, Preventing Diabetes in Medicare Act of 2013, all sections relating to vision. HR 1274, Access to Quality Diabetes Education Act of 2013, all sections relating to vision. HR 1285, To amend the Controlled Substances Act to make any substance containing hydrocodone a schedule II drug, all sections relating to vision. HR 1427, the Truth in Healthcare Marketing Act, all sections relating to vision. HR1915, Gestational Diabetes Act of 2013, all sections relating to vision. HR 2817, the Protect Patient Access to Quality Health Professionals Act of 2013, all sections relating to vision. S 452, Medicare Diabetes Prevention Act of 2013, all sections relating to vision. S 539, National Diabetes Clinical Care Commission Act, all sections relating to vision. S 621, Safe Prescribing Act of 2013, all sections relating to vision, all sections relating to visionS 907, Gestational Diabetes Act, all sections relating to vision. S 907, Gestational Diabetes Act, all sections relating to vision. S 945, Access to Quality Diabetes Education Act of 2013, all sections relating to vision. S 1445 National Health Service Corps Improvement Act of 2013, all sections relating to vision. S 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act, all sections relating to vision.

Client expense: $560,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2552, A bill to enhance beneficiary and provider protections and improve transparency in the Medicare Advantage market, and for other purposes, all provisions H.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisionsH.R. 1701, Cutting Costly Codes Act of 201, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions H.R. 1179, Improving Access to Medicare Coverage Act of 2013, all provisions S. 569, Improving Access to Medicare Coverage Act of 2013, all provisions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions H.R. 962, Medicare Diabetes Prevention Act of 2013, all provisions S. 452, Medicare Diabetes Prevention Act of 2013, all provisions H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act of 2013, all provisions S. 2348, Removing Barriers to Colorectal Cancer Screening Act of 2014, all provisions H.R. 3750, Telehealth Modernization Act of 2013, all provisions H.R. 3698, Two-Midnight Rule Delay Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, all provisions S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, all provisions H.R. 4302, Protecting Access to Medicare Act of 2014, provisions relating to the SGR patch Medicare program - Medicare Advantage Medicare program - SGR Repeal Medicare program - ICD-10 Repeal Medicare program - HIPAA (ICD-10, EFT) Medicare program - Physician payment and delivery reform issues Medicare program - Payment for short hospital stays Medicare program - Quality reporting penalty Medicare program - Independent Payment Advisory Board (IPAB) Medicare program - Medicare Patient Empowerment Act Medicare program - Funding for quality measure development Medicare program - Claims Data release Medicare program - Telemedicine Medicare program - Molecular diagnostics Medicare program - In-office Ancillary Services Exception Medicare program - Laboratory payments Medicare program - Graduate Medical Education Medicare program - Continuity of Care Medicare program - Coding Issues (Misvalued Codes and RUC Timeline) Medicare program - Current Procedural Terminology (CPT) Medicare program - Two-Midnight Rule Medicare program - Recovery Audit Contractors (RACs) Medicare program - Appeals backlog Medicare program - Program Integrity Medicare program - EHR Fraud Medicare program - Nursing home patients' access to Schedule II pain medication Medicare program - Physician identity theft Medicare program - Enrollment Medicare program - Grace period Medicare program - Exchanges Medicare program - Smart Cards Medicare program - Electronic Submission of Medical Documentation (esMD) Medicare program - Licensure Medicare program - Part D and Hospice Patients Medicare program - Physician Compare Medicare program - Conditions of Participation Medicare program - Quality resource use reports Medicare program - Physician Quality Reporting System (PQRS)Medicare program - Value-based modifier Medicare program - Narrow networks Medicare program - Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey Medicare and Medicaid programs - Meaningful Use of EHRs/Health Information Technology Medicare and Medicaid programs - Mental health care Medicaid program - Parity for primary care physician services

Client expense: $3,860,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Natl Drug Control Policy (NDCP), President of the U.S., SENATE, Treasury, Dept of, U.S. Secret Service, White House Office

HR 962 / S 452 - Medicare Diabetes Prevention Act of 2013; HR 1074 / S 539 - National Diabetes Clinical Care Commission Act; HR 1257 - Preventing Diabetes in Medicare Act; HR 1274 / S 945 - Access to Quality Diabetes Education Act of 2013; S 557 - Medication Therapy Management Empowerment Act; HR 3322 - Eliminating Disparities in Diabetes Prevention, Access and cAre Act of 2013; HR 2845 / S 1935 - Diabetic Testing Supply Access of 2013/14; H.R. 3591 - Minority Diabetes Initiative Act; HR 2415 / S 1184 - Treat and Reduce Obesity Act of 2013; and S 596 - Fostering Independence Through Technology Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Actof 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally; S. 1184 and H.R. 2415 Treat and Reduce Obesity Act of 2013; Diabesity amendment to S. 1871 SGR Repeal and Medicare Beneficiary Access; Physician Quality and Reporting System (PQRS)

Client expense: $440,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

S. 2176, the Commonsense Reporting Act of 2014 H.R. 4414, the Expatriate Health Coverage Clarification Act of 2014 H.R. 3474, the Hire More Heroes Act of 2014 H.R. 1814, the EACH ActH.R. 3979, the Emergency Unemployment Compensation Extension Act of 2014 S. 1729, Expanded Consumer Choice Act S. 1333, Increased Competition for Consumers Act S. 2069, Small Business Tax Credit Accessibility Act S. 2173, CHOICE Act H.R. 2575, the Save American Workers of 2014 H.R. 4118, the SIMPLE Fairness Act S. 2461, the CHIP Extension Act of 2014 S. 2446, Truth in Obamacare Accounting Act H.R.4865 / S.2434, Family Coverage Act H.R. 4406, Taxpayer Bailout Protection Act H.R. 4438, American Research and Competitiveness Act of 2014 H.R. 4106, Saving Lives, Saving Costs Act S. 2229, the Expanding Primary Care Access and Workforce Act H.R. 2663 / S. 1422, the Preventive Health Savings Act H.R. 4574, Strengthening Mental Health in Our Communities Act of 2014 H.R.3717, Helping Families in Mental Health Crisis Act of 2013 H.R.4775 / S.2462, Safeguarding Classrooms Hurt by ObamaCare's Obligatory Levies H.R. 3303, Sensible Oversight for Technology Which Advances Regulatory Efficiency (SOFTWARE) Act S. 2007, Preventing Regulatory Overreach To Enhance Care Technology (PROTECT) Act of 2014 H.R. 1074/S. 539, the National Diabetes Clinical Care Commission Act H.R.962/S. 452, the Medicare Diabetes Prevention Act H.R. 1024/ S. 557 the Medication Therapy Management Empowerment H.R. 4444, the Long-Term Studies of Comprehensive Outcomes and Returns for the Economy (SCORE) Act

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

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Act of 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of P.L. 111-148, The Patient Protection and Affordable Care Act; Title III - Improving the Quality and Efficiency of Health Care; S. 452/H.R. 962, The Medicare Diabetes Prevention Act of 2013; S. 351/H.R. 351, Protecting Senior's Access to Medicare Act of 2013; H.R. 2415/S. 1184. Treat and Reduce Obesity Act- All Provisions; H.R. 2663, To Amend the Congressional Budget Act Respecting Scoring of Prevention Health Savings - All Provisions; H.R. 4015/S.2000, The SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions.

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

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

H.R. 962 and S. 452 Medicare Diabetes Prevention Act of 2013; Issues related to Medicare Part D and Medicaid rebates as contained in P.L. 112-25 Budget Control Act of 2011 and H.R. 8 American Taxpayer Relief Act of 2012; H.R. 1588 & S. 740 Medicare Drug Savings Act of 2013; H.R. 1257 Preventing Diabetes in Medicare Act of 2013 and prediabetes generally; H.R. 1274 and S 945 Access to Quality Diabetes Education Act of 2013 (Diabetes Self-Management Training in Medicare);Medicare diabetes screening generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 452/H.R. 962, the Medicare Diabetes Prevention Act. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. H.R. 1249, the Common Sense Nutrition Disclosure Act. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. H.R. 1783, the School Food Modernization Act. H.R. 2343, the Healthy Food Financing Initiative. H.R. 1947, the Federal Agriculture Reform and Risk Management Act/S.954. H.R. 2663/S. 1422, the Preventive Health Savings Act. H.R. 3322, H.R. 3591, S. 1932. See next page.S. 452/H.R. 962, the Medicare Diabetes Prevention Act. Support entire bill providing for Medicare Coverage of National Diabetes Prevention Program. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. Support entire bill; provides funding for the establishment of a tracking and surveillance system at the Centers for Disease Control and Prevention and provides grant funding for public health research on gestational diabetes. H.R. 1249, the Common Sense Nutrition Disclosure Act. Oppose entire bill; makes exemptions to nutrition labeling in chain restaurants as required by the Patient Protection and Affordable Care Act. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. Support entire bill; requires states to report on and reach physical education benchmarks; and requires training of physical education teachers and school administrators; physical education curriculum; and dedicated school space for physical education and physical activity. H.R. 1783, the School Food Modernization Act. Support entire bill, provides loan guarantees and grants for schools to improve their facilities in order to prepare and serve healthier meals. H.R. 2343, the Healthy Food Financing Initiative. Support entire bill; to provide financing to expand or improve supermarkets, grocery stores and other retail food options in underserved areas in order to make healthier food options available. H.R. 1947, the Federal Agriculture Reform and Risk Management Act/S. 954, the Agriculture Reform, Food and Jobs Act (the Farm Bill). Support Healthy Food Financing Provision, to provide financing to expand or improve supermarkets, grocery stores and other retail food options in underserved areas in order to make healthier food options available. H.R. 2663/S. 1422, the Preventive Health Savings Act. Support entire bill; to require the Director of the Congressional Budget Office (CBO), upon a request by the chairman or ranking minority member of certain congressional committees, to determine if proposed legislation would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services H.R. 3322, Eliminating Disparities in Diabetes Prevention, Access and Care Act. Support entire bill; expands resources at NIH, CDC, HRSA, and IHS to promote research, treatment, and education regarding diabetes in minority populations. H.R. 3591, Minority Diabetes Initiative Act. Support entire bill; provides grants for improved diabetes care for minority populations. S. 1932, Better Care, Lower Cost Act. Support part of bill; establishes a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions, and for other purposes. Issues worked on the Hill not yet reflected in legislation: United States Preventive Services Task Forcesupport any efforts to require the USPSTF to update its recommendation for diabetes screening including gestational diabetes screening based on new evidence. Seek support for nomination of Dr. Elbert Huang to serve on the USPSTF. Support Surgeon General nominee Vivek Murthy. Special Diabetes Program educate Congress on the good work the program is doing in research and prevention and the need to reauthorize this program; Also support provision in the Senate Finance mark of the Sustainable Growth Rate which reauthorized the program for 5 years. Medicare Sustainable Growth Ratesupport efforts to include Medicare Diabetes Prevention Act and the Special Diabetes Program in moving legislation.

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

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

Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Middle Class Tax Relief and Job Promotion Act (H.R. 3630) 3.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 4.Implementation of Pandemic and All-Hazards Preparedness Act (Public Law 109-417) 5.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 6.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 7.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 8.Animal Drug and Animal Generic Drug User Fee Act (S. 622/H.R.___) 9.Healthier Lifestyles and Prevention America Act (S. 39) 10.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392) 11.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 12.Personal Health Investment Today Act (H.R. 956) 13.A bill to provide for a sequester replacement (S. 16) 14.American Family Economic Protection Act of 2013 (S. 388) 15.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933) 16.Regulations From the Executive in Need of Scrutiny Act of 2013 (S. 15 / H.R. 367) 17.To repeal the Prevention and Public Health Fund (H.R. 1099) 18.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 19.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 20.Physical Activity Guidelines for Americans Act (S. 531) 21.Firearm Safety and Public Health Research Act (H.R. 321) 22.Helping Sick Americans Now Act (H.R. 1549) 23.Energy Consumers Relief Act (H.R. 1582) 24.Common Sense Nutrition Disclosure Act (H.R. 1249) 25.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 26.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 27.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 28.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 29.FIT Kids Act (S. 1033/H.R. 2178) 30.Strengthening Americas Schools Act (S. 840) 31.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 32.Fit to Serve Act (S. 976) 33.Climate Change Health Protection and Promotion Act (H.R. 2023) 34.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 35.Student Success Act (H.R. 5) 36.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 37.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 38.Senate FY14 Labor, Health and Human Services, and Education Bill 39.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 40.Pharmacy Compounding Quality and Accountability Act (S. 959) 41.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 42.Drug Supply Chain Security Act (S. 957) 43.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 44.Healthy Families Act (H.R. 1286/S. 631) 45.FY2014 Continuing Resolution (H.J. Res. 59) 46.Drug Quality and Security Act (H.R. 3204) 47.Pharmaceutical Quality, Security and Accountability Act (S. 959) 48.Energy Consumers Relief Act (H.R. 1582) 49.Increasing the Safety of Prescription Drug User Act (not yet introduced proposed by Sen. Udall-NM) 50.National Energy Tax Repeal Act (S. 1324) 51.Saving Coal Jobs Act of 2013 (S. 1514) 52.Community Parks Revitalization Act (H.R. 2424) 53.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 54.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 55.Nutrition Reform and Work Opportunity Act (H.R. 3102) 56.Health Equity and Accountability Act (not yet introduced) 57.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 58.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 59.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 60.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 61.To provide direction to the Administrator of the Environmental Protection Agency regarding the establishment of standards for emissions of any greenhouse gas from fossil fuel-fired electric utility generating units, and for other purposes. (H.R. 3826) 62.Potential conference report for the Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102) 63.Senators Wyden and Isakson proposal on chronic disease care coordination in Medicare (not yet introduced) 64.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 65.Preventing Antibiotic Resistance Act (S. 1256) 66.The Consolidated Appropriations Act of 2014 67.Strategies to Address Antimicrobial Resistance (STAAR) Act 68.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 69.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 70.Electricity Security and Affordability Act (HR 3826) 71.Stop Overdose Stat Act (HR 4169) 72.Opioid Overdose Reduction Act (S. 2092/H.R. 4288)

Client expense: $33,000 · Firm income: Not reported

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

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 In all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 Medicare Diabetes Prevention Act of 2013; HR 1257 - Prevent Diabetes in Medicare Act of 2013; HR 1247/S 945 - Access to Quality Diabetes Education Act of 2013; HR 2663/ S 1422 Scoring of Preventive Health Savings; and S 1284 - Department of Labor, Health and Human Services and Education and Related Agencies Appropriations Act of 2014, specifically NDPP funding

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY 2014 Omnibus HR 3547 FY 2014 Continuing Resolution H J Res 106 PL 113-73 FY 2014 Continuing Resolution H J Res 59 PL 113-67 HR 4302 SGR Patch Protecting Access to Medicare Act of 2014 - Public Law No: 113-93 In all of the above the specific issues included potential Medicare offsets that might be applied to prescription drugs HR 962/S 452 - Medicare Diabetes Prevention Act of 2013 HR 1257 Prevent Diabetes Medicare Act of 2013 HR 1274/S 945 Access to Quality Diabetes Education Act of 2013; HR 1588/ S 740 -- Medicare Drug Savings Act of 2013 HR 2415/ S 1184 - Treat and Reduce Obesity Act of 2013; HR 2663/S 1422 - Scoring of Preventive Health Savings Medicare diabetes screening and self management

Client expense: Not reported · Firm income: $27,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Access to Rehabiliation Services Act (H.R. 713/S.367) Medicare Diabetes Prevention Act (S. 452) Medicare SGR Reform (Senate Finance draft, House Ways & Means draft) Medicare SGR Repeal & Beneficiary Access Improvement Act (S.2110)Medication Therapy Management Act of 2013 (H.R. 1024/S.557) Pathway for SGR Reform Act (temporary extension of Medicare extenders) (H.J. Res.59) Proposed Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs for Contract Year 2015 (CMS-4159-P) Protecting Access to Medicare Act (H.R.4302) Recruiting Individuals to Drive our Elders (RIDE) Act-not yet introduced SGR Repeal and Medicare Beneficiary Access Act (S.1871& H.R.2810)

Client expense: $174,517 · Firm income: Not reported

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