Improving Access to Medicare Coverage Act of 2013

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 111-148 - The Patient Protection and Affordable Care Act HR 1179 and S. 569 - Improving Access to Medicare Coverage Act of 2013 Post-acute payment and reform issues Dept. of VA (VA) Provider Agreement Proposed Rule RIN 2900-A015 HR 2087 - Arbitration Fairness Act of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 111-148 - The Patient Protection and Affordable Care Act HR 1179 and S. 569 - Improving Access to Medicare Coverage Act of 2013 Post-acute payment and reform issues Dept. of VA (VA) Provider Agreement Proposed Rule RIN 2900-A015 HR 2087 - Arbitration Fairness Act of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 111-148 - The Patient Protection and Affordable Care Act HR 1179 and S. 569 - Improving Access to Medicare Coverage Act of 2013 Post-acute payment and reform issues Dept. of VA (VA) Provider Agreement Proposed Rule RIN 2900-A015 HR 2087 - Arbitration Fairness Act of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Post-acute care policy. H.R. 1179/S. 569, Improving Access to Medicare Coverage Act of 2013 H.R. 4994/S.2553 Improving Medicare Post Acute Transformation Act of 2014 S. 1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1458 BACPAC of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) H.R. 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) H.R. 4994/S 2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) H.R. 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S 1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Title II, Section 202 H.R. 5110 SAVE Medicare Home Health Act of 2014 (all sections) H.R. 3245 Medicare Home Health Fraud Reduction Act (all sections) H.R. 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 Modification of Medicare Home Health Surety Bond Condition of Participation Requirement H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015 (all sections) H.R. 1458 BACPAC of 2015 (all sections) H.R. 1250/S 1211 A bill to amend title XVIII of the Social Security Act to provide that payment under the Medicare program to a long-term care hospital for inpatient services shall not be made at the applicable site neutral payment rate for certain discharges involving severe wounds, and for other purposes (all sections) H.R. 2208 Hospice CARE (all sections) H.R. 6 21st Century Cures Act H.R. 2196/S 971 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) H.R. 441/S 202 To provide for a technical change to the Medicare long-term care hsopital moratorium exception (all sections) S 1549 Care Planning Act of 2015 (all sections) Other Issues Related to Post-Acute Care Policy

Client expense: $412,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

PL 111-148 - The Patient Protection and Affordable Care Act HR 1179 and S. 569 - Improving Access to Medicare Coverage Act of 2013 Post-acute payment and reform issues Dept. of VA (VA) Provider Agreement Proposed Rule RIN 2900-A015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1179 and S. 569, Improving Access to Medicare Coverage Act of 2013. Post-acute payment and reform issues. S.739/H.R. 1369: Veterans Access to Extended Care Act and VA Provider Agreement and Proposal Health information technology issues Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Veterans Affairs, Dept of (VA)

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 111-148 - The Patient Protection and Affordable Care Act HR 1179 and S. 569 - Improving Access to Medicare Coverage Act of 2013 Post-acute payment and reform issues Dept. of VA (VA) Provider Agreement Proposed Rule RIN 2900-A015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1179 and S. 569, Improving Access to Medicare Coverage Act of 2013. Post-acute payment and reform issues. S.739/H.R. 1369: Veterans Access to Extended Care Act Health information technology issues Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: $920,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Veterans Affairs, Dept of (VA)

HR 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) HR 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) HR 4994/S2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) HR 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Ttile II, Section 202 HR 5110 SAVE Medicare Home Health Act of 2014 (all sections) HR 3245 Medicare Home Health Fraud Reduction Act (all sections) Other Issues Related to Post-Acute Care Policy HR 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 Modification of Medicare Home Health Surety Bond Condition of Participation Requirement HR2 Medicare Access and CHIP Reauthorization Act of 2015 (all sections) HR1458 BACPAC of 2015 (all sections)

Client expense: $630,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

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

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

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

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

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

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

Issues related to long-term care providers including S. 501, Fostering Independence through Technology Act H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013 SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 1179, Improving Access to Medicare Coverage Act of 2013 S. 569, Improving Access to Medicare Coverage Act of 2013

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

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

H.R. 1179/S. 569,Improving Access to Medicare Coverage Act; DEA nurse agent issues; SGR issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, comparative effectiveness research, quality reporting and improvement initiatives.Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. P.L. 112-096, the Middle Class Tax Relief and Job Creation Act of 2012 - issues related to Medicare and Medicaid physician payments. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Medicare physician payment issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare 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 Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicaid program - Parity for primary care physician services Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Public Law No: 113-46, Continuing Appropriations Act , 2014 - Medicare and Medicaid savings issues. Public Law 113-93 - The Protecting Access to Medicare Act of 2014 Discussions with congressional staff on misvalued coding issues.

Client expense: Not reported · Firm income: $75,000

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

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, entire bill 7. S. 740, Medicare Drug Savings Act of 2013, entire bill 8. H.R. 1588, Medicare Drug Savings Act of 2013, entire bill 9. S. 1198, Medicare Fair Share Act of 2013, entire bill 10. H.R. 4015, SGR Repeal and Medicare Provider Modernization Act of 2014, entire bill 11. H.R. 4302, Protecting Access to Medicare Act of 2014, entire bill 12. H.R. 1179, Improving Access to Medicare Coverage Act of 2013, entire bill 13. S. 569, Improving Access to Medicare Coverage Act of 2013, entire bill

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

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

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. 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. 647, Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014), provisions relating to Misvalued Codes S. 313, Achieving a Better Life Experience Act of 2013 (ABLE Act of 2013), provisions relating to Misvalued Codes H.R. 962, Medicare Diabetes Prevention Act of 2013, all provisions S. 452, Medicare Diabetes Prevention Act of 2013, all provisions H.R. 4282, Creating Access to Residency Education Act of 2014, all provisions H.R. 4843, Native Contract and Rate Expenditure Act of 2014 (Native CARE 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 H.R. 4998, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions S. 2552, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions H.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, all provisions H.R. 5723, Ensuring Access to Primary Care for Women & Children Act, all provisions S. 2694, Ensuring Access to Primary Care for Women & Children Act, all provisions H.R. 5780, Protecting the Integrity of Medicare Act (PIMA) of 2014, all provisions H.R. 4302, Protecting Access to Medicare Act of 2014, provisions relating to coding and pricing issues Medicare program: SGR Repeal Medicare program: Independent Payment Advisory Board (IPAB) Repeal Medicare program: Medicare Patient Empowerment Act Medicare program: Graduate Medical Education Medicare program: ICD-10 Repeal Medicare program: Overlapping Medicare incentive programs Medicare program: HIPAA including ICD-10 Medicare program: Electronic Health Records (EHR) - Meaningful Use Medicare program: EHR Certification Medicare program: Physician Quality Reporting System (PQRS) Medicare program: Laboratory Developed Tests Medicare program: Alternative Payment Models/quality performance measures Medicare program: Physician payment and delivery reform issues Medicare program: Hospital short stay Medicare program: Medicare funding for quality measure development Medicare program: Value-Based Modifiers Medicare program: Global Surgical Codes Medicare program: In-Office Ancillary Services Exception Medicare program: RUC - Misvalued and Care Coordination Codes Medicare program: Diabetes Medicare program: Recovery Audit Contractors Medicare program: Program Integrity - Meaningful Use Audits Medicare program: Program Integrity - Modifiers Medicare program: Program Integrity - Electronic Health Records Medicare and Medicaid programs: Coverage of lung cancer screening for high-risk patients

Client expense: $4,390,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

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

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

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

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues;implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage financing for infectious disease such as Ebola; and other issues relating to health care reform implementation. *AddMACPACtoAgencyList

Client expense: $2,230,000 · Firm income: Not reported

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

Support HR 1179/S 569, to solve the Medicare observation days problem by counting all time spent in a hospital bed toward the 3-day stay requirement for Medicare coverage of post-acute care. Support HR 334, Medicare Adult Day Services Act, to enable beneficiaries eligible for home health services to receive them in a certified adult day services center. Support HR 2504/S 1332, Home Health Care Planning Improvement Act. Allows Medicare coverage of home health services provided by a nurse practitioner, clinical nurse specialist, certifie4d nurse-midwife or physician assistant under a physician's supervision. Support S 596, Fostering Independence Through Technology, authorizing Medicare pilot projects on remote monitoring by home health agencies.

Client expense: $57,866 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay. H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders . H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program. H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies. H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding. Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders. S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud. S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks. S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Observation Stay Legislation H.R. 1179/S. 569 entire legislation NOTICE ACT H.R. 5232 entire legislation

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1179 and S. 569, Improving Access to Medicare Coverage Act of 2013. Post-acute payment and reform issues. Dept. of VA Provider Agreement Proposed Rule RIN 2900-A015Health information technology issues Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: $820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increased Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013.S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367: The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness For Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodalogy for short inpatient hospitals stays. H.R. 3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.2157: Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014. Advocacy work on HCBS proposed rule: passsed in January. S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. H.R. 1250: The Medicare Audit Improvement Act of 2013. S. 1012: Medicare Audit Improvement Act of 2013. S. 2082: The two-midnight rule coordinator and Improvement Act of 2014. Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014). Protect and Preserve Medicaid funding for Long Term Services and Supports Medicaid Provider Assessement. Improving the CMS State Plan Amdt. Process. Opposition to H.B. No. 5051 An Act Improving Transparency of Nursing Home Operations. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. Improving Medicare Post-Acute Care Transformation Act (IMPACT) Department of VA Provider Agreement proposaed rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors. MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). H.R. 4994, IMPACT Act of 2014.H.R. 5098: To amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. H.R. 5232: A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. H.R. 5373: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

Client expense: $820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

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

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

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

PL 111-148 - The Patient Protection and Affordable Care Act HR 1179 and S. 569 - Improving Access to Medicare Coverage Act of 2013 Post-acute payment and reform issues Dept. of VA (VA) Provider Agreement Proposed Rule RIN 2900-A015

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

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

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

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

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

HR 4872 to limit cuts to nursing homes under Medicare. Medicare & Medicaid Policy 1179 S569. SGR legislation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) HR 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) HR 4994/S 2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) HR 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Title II, Section 202 HR 5110 SAVE Medicare Home Health Act of 2014 (all sections) HR 3245 Medicare Home Health Fraud Reduction Act (all sections) Other issues related to Post-Acute Care Policy HR 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 modification of Medicare Home Health surety bond condition of participation requirement

Client expense: $490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Physician Payment Reform and SGR repeal; Medicare observation status and the two midnight Rule; H.R. 1179/S.569, Improving Access to Medicare Coverage Act of 2013; H.R. 4188, "Establishing Beneficiary Equity in the Hospital Readmission Program Act;" H.R. 1173, "Personalize Your Care Act of 2013"; "Ensuring Access to Primary Care for Women & Children Act," H.R. 5723, S. 2694. Meaningful use and hospitalists. H.R. 5780, Protecting the Integrity of Medicare Act of 2014, gainsharing provisions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CMS Implementation of SNF PPS FY15 PPS rules; H.R. 4999, the IMPACT Act; S 569/H.R. 1177/H.R. 3531 redefining hospital observation days; and provisions of H.R. 4015, S 1871, S 2000 and S 2110 addressing SGR repeal with specific attention to provisions affecting therapy; and CMS CY15 rules for Medicare Professional Services and related rulemaking for home health agencies, ESRD and DMEPOS

Client expense: $76,000 · Firm income: Not reported

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

Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office). (No bill.) Proposals related to the activities of the Federal Coordinated Health Care Office intended to improve the quality of care for recipients receiving benefits from both Medicare and Medicaid, i.e., dual-eligibles. Medicare Advantage. S. 2552, H.R.4998, Medicare Advantage Participant Bill of Rights Act of 2014: provisions to establish necessary protections for seniors enrolled in Medicare Advantage plans. Medicare Benefit Redesign. S. 11, Fiscal Sustainability Act of 2013: provisions pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Drug Savings. S. 740, H.R. 1588, Medicare Drug Savings Act of 2013: provisions to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by people eligible for both Medicare and Medicaid (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Part D Negotiation of Drug Prices. S. 408, H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: proposals to create a Medicare-operated prescription drug plan, allowing or requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare Physician Fees and Extenders. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014; S. 2157, Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: provisions relating to a permanent fix of the sustainable growth rate (SGR) formula used to determine physician fees under Part B; the extension of the Qualified Individual (QI) program; and the therapy caps. Medicare Supplemental Health Insurance. (No bill.) Proposals to increase costs for Medicare beneficiaries who purchase Medigap insurance. Medicare Observation Status. S. 569, H.R. 1179, Improving Access to Medicare Coverage Act of 2013: legislation to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Nursing Home Staffing. H.R. 5373, Put A Registered Nurse in the Nursing Home Act of 2014: legislation to require nursing homes and skilled nursing facilities that receive Medicare and/or Medicaid reimbursement to have at least one direct care registered nurse on duty at all times. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Economic Council (NEC), Office of Management & Budget (OMB), President of the U.S., SENATE, Social Security Administration (SSA), Treasury, Dept of, Vice President of the U.S.

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574, Prevention of Fraud, Waste, and Abuse: H.R. 2305 and H.R. 3090 and S. 1123 and S. 1019 and H.R. 4998 and S. 2552, Savings on Medical Expenses: H.R. 4104 and H.R. 1179 and S. 569, Workforce Advancements: S. 2251 and H.R. 4445.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3144 Fairness for Beneficiaries Act of 2013 HR 1179, S. 569 Improving Access to Medicare Coverage Act of 2013

Client expense: Not reported · Firm income: $18,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 569/H.R. 1179, Improving Access to Medicare Coverage Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

DEA nurse agent issues; Medicare sustainable growth rate issue; S. 569/H.R. 1179, Improving Access to Medicare Coverage Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE