Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013

S 367/HR 713 - Medicare Access to Rehabilitation Services Act: Advocate for removal of cap on occupational therapy services and passage. HR 942/S 948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013: Advocate for inclusion of occupational therapy professionals as providers of complex rehabilitation technology. No bill# - Educate about role of occupational therapy in primary care. HR 2810 - The Medicare Patient Access and Quality Improvement Act of 2013: Advocated regarding sustainable growth rate and educate about the role of occupational therapy in health care and need for improving Medicare to assure that patients receive appropriate care, especially occupational therapy services, and that payment is fair and equitable. No bill# - Multiple Procedure Payment Reduction (MPPR): Advocate the separation of occupational therapy from physical therapy/speech language pathology in application of MPPR policy. No bill# - Manual Medicare Review (MMR: Advocate for improved MMR procedures including electronic submission and 10 day turn around. S 1871/S 2110 - the Sustainable Growth Rate (SGR) Repeal and Medicare Beneficiary Access Improvement Act of 2013 AND HR 4015/S 2000 - SGR Repeal and Medicare Provider payment Modernization Act of 2014: Advocated for improvements to the bills that address policies that pertain to beneficiaries' access to occupational therapy services and how occupational therapy services are reimbursed under the Medicare program. Advocate for repeal of the Medicare Part B outpatient therapy cap on occupational therapy services. HR 3749 - The Medicare Demonstration of Coverage for Low Vision Devices Act: Support for greater attention to low vision coverage and highlight role of occupational therapy in ensuring the devices are utilized properly and to their full potential. S 1932/HR 3890 - Better Care, Lower Cost Act: Educate about role of occupational therapy in helping people with chronic conditions. Support including occupational therapy in the chronic care innovation centers. HR 4994/S 2553 0 The Improving Medicare post-Acute Care transformation Act of 2014 "IMPACT Act of 2014": Advocated for improvements in the bill that would help ensure Medicare beneficiaries' access to quality post-acute care in the right setting is preserved. Advocated to ensure data collection program includes elements that reflect the contributions of occupational therapy across the various post-acute settings. HR 5380 - Medicare Telehealth Parity Act: Support passage and inclusion of occupational therapy services. HR 3306 - The Telehealth Enhancement Act of 2013: educate about how occupational therapy can be utilized in telehealth. HR 3877 - Lymphedema Treatment Act: Support passage and educate about role of occupational therapy services. No. bill# (PL 113-93) - Advocate for inclusion of occupational therapy in the Excellence in Mental Health Act's Medicaid Demonstration by encouraging Members of Congress to send a letter of support to the Substance Abuse and Mental Health Administration. HR 5547/S 2515 - Community Integration Act: Discussed Act's aims to strengthen Medicaid beneficiaries' opportunities to receive home and community-based services. Met with staff from the Health Resources and Services Administration (HRSA), including Dr. Marcia Brand, HRSA Deputy Administrator, along with other representatives of allied health professionals, to discuss recent restructuring of HRSA that appears to deemphasize allied health professions and lack of funding for allied health training programs. Also discussed the need to clearly define "allied health professionals" both for existing policies and new programs being developed at the Centers for Medicare and Medicaid Innovation; and the role of allied health professionals in the changing health care landscape.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

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

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111-152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare; HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 152: Older Americans Act Reauthorization Act of 2013; S 423/HR 564: Family-to-Family Health Information Centers; HR 3850/HR 4122: Older Americans Act Reauthorization Act of 2014; HR 3114: Helping Families & Seniors Save on Health Care Act of 2014; HR 4118: SIMPLE (Suspending the Individual Mandate Penalty Law Equals) Fairness Act of 2014; HR 4302: Protecting Access to Medicare Act of 2014; S 2110: Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014; S 2410/HR 4435: National Defense Authorization Act 2015; S 2449/HR 4631: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014; S 531: Promoting Physical Activity for Americans Act; S 2539: TBI Reauthorization Act; S 531: Physical Activity Guidelines; and S 1847: National Defense Authorization Act.

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013; H.R. 4920 and S. 2975 Medicare DMEPOS Competitive Bidding Improvement Act

Client expense: $109,572 · Firm income: Not reported

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

Develop a legislative and regulatory strategy to lobby and obtain a separate benefit classification for complex rehab technology (H.R. 942, S. 948.

Client expense: Not reported · Firm income: $13,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions; H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920/ H.R. 5809/S.2975 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

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

Develop a legislative and regulatory strategy to lobby and obtain a separate benefit classification for complex rehab technology (H.R. 942, S. 948).

Client expense: Not reported · Firm income: $13,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

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

S 367/HR 713 - Medicare Access to Rehabilitation Services Act: Advocate for removal of cap on occupational therapy services and passage of bills. HR 942/S 948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013: Advocate for inclusion of occupational therapy professionals as providers of Complex Rehabilitation Technology. No bill# - Educate about role of occupational therapy in primary care. HR 2810 - The Medicare Patient Access and Quality Improvement Act of 2013: Advocated regarding Sustainable growth rate and educate about the role of occupational therapy in health care and need for improving Medicare to assure that patients receive appropriate care, especially occupational therapy services, and that payment is fair and equitable. No bill# - Multiple Procedure Payment Reduction (MPPR): Advocate for separation of occupational therapy from physical therapy/speech language pathology in application of MPPR policy. No bill# Manual Medicare Review (MMR): Advocate for improved MMR procedures including electronic submission and 10 day turn around. S 1871/S 2110 - the Sustainable Growth Rate (SGR) Repeal and Medicare Beneficiary Access Improvement Act of 2013 AND HR 4015/S 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Advocated for improvements to the bills that address policies that pertain to beneficiaries' access to occupational therapy services and how occupational therapy services are reimbursed under the Medicare program. Advocate for repeal of the Medicare Part B outpatient therapy cap on occupational therapy services. HR 3749 - The Medicare Demonstration of Coverage for Low Vision Devices Act: Support for greater attention to low vision coverage and highlight role of occupational therapy in ensuring the devices are utilized properly and to their full potential. S 1932/HR 3890 - Better Care, Lower Cost Act: Educate about role of occupational therapy in helping people with chronic conditions. Support including occupational therapy in the chronic care innovation centers. HR 4994/S 2553 - The Improving Medicare Post-Acute Care Transformation Act of 2014 "IMPACT Act of 2014": Advocated for improvements in the bill that would help ensure Medicare beneficiaries' access to quality post-acute care in the right setting is preserved. Advocated to ensure data collection program included elements that reflected the contributions of occupational therapy across the various post-acute settings. HR 5380 - Medicare Telehealth Parity Act: Support passage and inclusion of occupational therapy services. HR 3306 - The Telehealth Enhancement Act of 2013: Educate about how occupational therapy can be utilized in telehealth. HR 3877 - Lymphedema Treatment Act - support passage and educate about role of occupational therapy services. No bill# (PL 113-93) - Advocate for inclusion of occupational therapy in the Excellence in Mental Health Act's Medicaid Demonstration by encouraging Members of Congress to send a letter of support to the Substance Abuse and Mental Health Administration.

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare;HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 152: Older Americans Act Reauthorization Act of 2013; S 423/HR 564: Family-to-Family Health Information Centers; HR 3850/HR 4122: Older Americans Act Reauthorization Act of 2014; HR 3114: Helping Families & Seniors Save on Health Care Act of 2014; HR 4118: SIMPLE (Suspending the Individual Mandate Penalty Law Equals) Fairness Act of 2014; HR 4302: Protecting Access to Medicare Act of 2014; S 2110: Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014; S 2410/HR 4435: National Defense Authorization Act 2015; S 2449/HR 4631: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014; and S 531: Promoting Physical Activity for Americans Act.

Client expense: $52,871 · Firm income: Not reported

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act

Client expense: $115,439 · Firm income: Not reported

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

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions; H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

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

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions;H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

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

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare;HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 152: Older Americans Act Reauthorization Act of 2013; S 423/HR 564: Family-to-Family Health Information Centers; HR 3850/HR 4122: Older Americans Act Reauthorization Act of 2014; HR 3114: Helping Families & Seniors Save on Health Care Act of 2014; HR 4118: SIMPLE (Suspending the Individual Mandate Penalty Law Equals) Fairness Act of 2014; HR 4302: Protecting Access to Medicare Act of 2014; S 2110: Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014; S 2410/HR 4435: National Defense Authorization Act 2015; and S 2449/HR 4631: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014.

Client expense: $86,759 · Firm income: Not reported

Develop a legislative and regulatory strategy to lobby and obtain a separate benefit classification for complex rehab technology (H.R. 942, S. 948).

Client expense: Not reported · Firm income: $13,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 713/S. 367-Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) Payments to Physical Therapists under the Medicare Physician Fee Schedule Permanent Repeal of/alternatives to the Sustainable Growth Rate (SGR) Formula H.R. 574 Medicare Physician Payment Innovation ActOpposition of Multiple Procedure Payment Reduction for PT Services Physician Quality Reporting System H.R. 2914 Promoting Integrity in Medicare Act H.R. 1310 and S. 236 Medicare Patient Empowerment Act Prevention Initiatives for Fraud and Abuse in the Medicare program Accountable Care Organizations/Patient Centered Medical Homes Electronic Health Records/ Health Information Technology incentives for Physical Therapists Development of Alternatives to Medicare Therapy Cap 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 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 Post-Acute Care Reform Common assessment tool for Medicare post-acute care Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act 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 MIPS H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 Post-Acute Care Reform Bill 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 Medicare Advantage 2015 Call Letter Comment letter for FY 2015 IPPS: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals. 2-midnight criteria, short stays, observation status. FY 2015 LTCH Long Term Care Hospital Prospective Payment Systems proposed rule. 2-midnight criteria, short stays, observation status Improving Medicare Post Acute Care Transformation Act (IMPACT) H.R. 4994/S.2553 Comments on RFI Provider Non-discrimination Statement for the record on Ways and Means Health Subcommittee Current Hospital Issues in Medicare Exchange and Insurance Market Standards for 2015 and Beyond Comments: 90 day grace period and network adequecy Letter of Support for Medicare coverage of functional electrical stimulation (FES) devices for post-stroke foot drop Prior authorization for DME Locum tenens SNF&IRF PPS F2015

Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities.Advocated for Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 which creates a separate benefit under Medicare for customized wheelchairs and equipment. (HR 942/S. 948). Discussed legislative options for improved access to wheelchair repair, capped rental equipment and speech-generating devices. Advocated for Access to Inpatient Rehabilitation Therapy Act of 2014(H. R. 4755) which includes recreational therapy among the therapy modalities that constitute an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Discussed suggested improvements for collecting data on patients within the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) which addresses data collectin procedures on rehabilitiation treatments and therapies under Medicare. Discussed personal injury settlements under Medicare affecting individuals with disabilities. Advocated for improved access for consumers to telemedicine and advocated for the lifting of restrictions of reimbursement for telemedicine at Accountable Care Organizations. Discussed strategies to improve information sharing for ACA navigators for the purpose of helping them enroll people with disabilities into the right health care plans.

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

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions;H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

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

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act

Client expense: $151,710 · Firm income: Not reported

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

Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities. Discussed passage of House and Senate legislation, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 -HR 942/S 948. Discussed raising the capped rental rule on some complex rehab technology products and accessories. Discussed possible solutions around improved access to wheelchair repair. Discussed next steps regarding FDA action around biosimilar regulation and the implementation of biosimilar clinical trials. Discussed opposition to restricting Medicare coverage of protected classes of prescription drugs under Medicare Part D. Discussed solutions regarding Medicare physician payment updates known as the 'doc fix' including the repeal of the therapy cap. Discussed solutions regarding Medicare and Medicaid secondary payer regulations. Discussed solutions with state governments and Federal agencies regarding the administration of Medicaid Managed Care programs to ensure protections are in place for people with disabilities. Discussed solutions around CMS guidance on home and commuity based settings. Promote adequate fudning for all Medicaid services that allow people with disabilities to remina in their homes and contribute to the community. Discussed solutions to Medicare's current competitive acquisition program and support - Medicare DMEPOS Market Pricing Program Act of 2013 - HR 1717 Discussed solutions around improved quality measures for home and community based services for the aging and disability communities with HHS. Support advocacy efforts to expand Medicaid.

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

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 Locum Tenens 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 :EHR Comments Medicare Physician Payment Innovation Act PFS PPS - Functional Limitation Reporting Therapy Cap: Manual Medical Review Essential Health Benefits Medicare Physician Fee Schedule Final Rule 2013 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 Post-Acute Care Reform Common assessment tool for Medicare post-acute care Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act H.R. 942 and S. 948 Ensuring Access to Quality Complex Rehabilitation Technology H.R. 2810 Medicare Patient Access and Quality Improvement Act IRF setting proposed measures related to function based on the CARE PAC Tool elements comments Proposed LTCH Quality measures for patient function based on the CARE PAC data items for the LTCH setting. Inclusion of physical therapists in MIPS H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 Post-Acute Care Reform Bill 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 Medicare Advantage 2015 Call Letter

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare;HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 152: Older Americans Act Reauthorization Act of 2013; S 423/HR 564: Family-to-Family Health Information Centers; HR 3850/HR 4122: Older Americans Act Reauthorization Act of 2014; HR 3114: Helping Families & Seniors Save on Health Care Act of 2014; HR 4118: SIMPLE (Suspending the Individual Mandate Penalty Law Equals) Fairness Act of 2014; HR 4302: Protecting Access to Medicare Act of 2014; and S 2110: Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014.

Client expense: $80,535 · Firm income: Not reported

H.R. 460, Patients' Access to Treatments Act, support legislation's intention to control the cost of prescription medications.--H.R. 942/S. 948, Access to Quality Complex Rehabilitation Technology Act, support all provisions. --H.R. 4302/P.L. 119-93, Protecting Access to Medicare Act, support delay of cut to reimbursements fof Medicare physicians and extensions of the Medicare therapy caps exceptions process.

Client expense: $295,826 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013

Client expense: $197,069 · Firm income: Not reported

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

Develop a legislative and regulatory strategy to lobby and obtain a separate benefit classification for complex rehab technology (H.R. 942, S. 948).

Client expense: Not reported · Firm income: $13,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/ S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions;H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - Medicare Patient Access and Quality Act of 2013, all provisions; S. 1871 - The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013, all provisions; H.R. 4302- Protecting Access to Medicare Act of 2014, all provisions.

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

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, competitive rates for Medicaid bidding and fraud abuse; H.R. 942/S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013, all provisions; (see contination page)H.R 27, Small Supplier Fairness in Building Competition Act of 2013, all provisions. H.R. 1717, Medicare DEMPOS Market Pricing Program Act of 2013, all provisions. H.R. 2375, Transparency and Accountability in Medicare Bidding, Act of 2013, all provisions. H.R. 2810, Medicare Patient Access and Quality Act of 2013, all provisions. S. 1871, The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013, all provisions. H.R. 4302, Protecting Access to Medicare Act of 2014, all provisions.

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

Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities.HR 942/S. 948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 Creates a separate benefit category under Medicare for CRT, protecting access to these customized products so that people living with significant disabilities, including MS, can remain independent and address their medical needs. Advocate for improved benefits and services under Medicare and Medicaid for people with disabilities. Supports HR 1717 - The Medicare DMEPOS Market Pricing Program Act of 2013/HR 1717 will replace the poorly designed bidding program at the Centers for Medicare and Medicaid Services (CMS) with a market pricing program to ensure that access to quality equipment and services is protected.

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

Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, White House Office

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare;HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; and S 423/HR 564: Family-to-Family Health Information Centers.

Client expense: $65,018 · Firm income: Not reported

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 Locum Tenens 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 :EHR Comments Medicare Physician Payment Innovation Act PFS PPS - Functional Limitation Reporting Therapy Cap: manual Medical Review Essential Health Benefits Medicare Physician Fee Schedule Final Rule 2013 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 Part B Inpatient Billing Proposed Rule Comments Nerve Conduction Studies and EMG LCD Comments for various MACs 2013 EMG Payment Reductions Medicare Improvement Standards Bundled Payment Models Post-Acute Care Reform Common assessment tool for Medicare post-acute care Manual Medical Review Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act Debt ceiling package 2014 OPPS Rule 2014 IPPS rule NCD to add CHF to cardiac rehabilitation H.R. 942 and S. 948 Ensuring Access to Quality Complex Rehabilitation Technology H.R. 2810 Medicare Patient Access and Quality Improvement Act

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; Tax Reform Act of 2013, all provisions; H.R. 942/S. 948, Ensuring Access to Quality Complex Rehabilitation Act of 2013, all provisions; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013, all provisions; (see contination page)H.R 27, Small Supplier Fairness in Building Competition Act of 2013, all provisions. H.R. 1717, Medicare DEMPOS Market Pricing Program Act of 2013, all provisions. H.R. 2375, Transparency and Accountability in Medicare Bidding, Act of 2013, all provisions. H.R. 2810, Medicare Patient Access and Quality Act of 2013, all provisions. S. 1871, The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013, all provisions.

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

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013

Client expense: $116,434 · Firm income: Not reported

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

Develop a legislative and regulatory strategy to lobby and obtain a separate benefit classification for complex rehab technology (H.R. 942, S. 948).

Client expense: Not reported · Firm income: $12,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; Tax Reform Act of 2013, all provisions; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/ S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions;H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - Medicare Patient Access and Quality Act of 2013, all provisions; S. 1871 - The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013, all provisions.

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

Develop a legislative and regulatory strategy to lobby and obtain a separate benefit classification for complex rehab technology (H.R. 942, S. 948)/

Client expense: Not reported · Firm income: $12,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid Managed Care. Implementation of the Medicaid Community First Allignment of Medicare and Medicaid for dually eligible recipients. Choice Option and Balancing Incentives Program. Preservation of Medicaid as an entitlement program. Access to Rehabilitation in Medicare. Preservatiion of Medicare.Medicaid eligibility changes in the Affordable Care Act. Achieving a Better Life Experience Act legislation, H.R. 647, S. 313. Implementation of the Affordable Care Act, P.L. 111-148 and P.L. 111-192, including Medicaid Health and Long Term Services and Supports provisions. Quality measures for long term services and supports in Medicaid Managed Care and payment alignment initiatives for beneficiaries of both Medicare and Medicaid. Medicare Secondary Payer Futures proposal. Long Term Care Commission. S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, and post accute care issues.

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

Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities.Promote Congressional support of H.R. 942/S.948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013. This legislation creates a separate benefit for complex rehab technology under Medicare for individuals with significant disabilities and functional limitations. United Spinal discussed concerns with the Centers for Medicare and Medicaid Services (CMS) regarding access to wheelchair repair under CMS' competitive acquisition program and outside of competitive acquisition areas across the country. United Spinal raised concerns with CMS regarding the Affordable Care Act healthcare marketplaces and navigator training to ensure consumer protections for enrollees. United Spinal discussed with the Department of Health and Human Services' Administration for Community Living access to the right type of wheelchair equipment, H.R. 942/S.948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 (described above) and related wheelchair coding issues, concerns with consumer protections under Medicaid, essential health benefits under the Affordable Care Act and respite care funding matters. In June 2012, Medicare issued an Advanced Notice of Proposed Rulemaking (ANPRM) that seeks to significantly expand Medicare Secondary Payer authority to require that current Medicare beneficiaries and non-beneficiaries project what their future medical needs may be related to the accident, injury or illness in question and then place settlement funds in trust to ensure future medical treatment is fully funded before the beneficiary can access any additional settlement funds. United Spinal raised our concerns regarding the need for consumer protections in this regulation and met with the White House, Congress and CMS. United Spinal signed on to a letter to the Director of the Medicare-Medicaid Coordination Office at the Centers for Medicare and Medicaid Services. The letter thanked the office for providing states with an opportunity to apply for funding to develop independent Demonstration Ombudsman Programs. United Spinal and a host of other organizations have been recommending that CMS require ombudsmen for dual demonstration projects. United Spinal submitted comments to the Centers for Medicare and Medicaid Services regarding their proposed policy of converting complex rehab technology (Medicare beneficiary customized purchase items) to capped rental items. United Spinal supports Part D Beneficiary Appeals Fairness Act, S. 1365/H.R. 2827 which permits Medicare Part D beneficiaries to request lower co-pays for high-cost specialty drugs used to treat chronic illnesses. Healthcare Coalition Protecting Dialysis Care United Spinal signed onto a letter to CMS Administrator Marilyn Tavenner opposing a proposed 9.4% cut to dialysis care. This significant cut is likely to result in restrictions in access or have other negative effects on patient care. United Spinal supports Medicare Access to Rehabilitation Services Act of 2013 (H.R 713/S. 367) and have raised our concerns with CMS and Congress. United Spinal raised concerns with the White House regarding recent companionship regulations and matters around institutionalization for the disability community as well as our support of improvements to the provision of home and community-based services. United Spinal supports the Medicare DMEPOS Market Pricing Program Act of 2013/H.R. 1717 which replaces CMS' current competitive acquisition program to allow for imporved choces of medical equipment providers for Medicare beneficiaries.

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; Tax Reform Act of 2013, all provisions; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/ S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions;H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions.

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

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; Tax Reform Act of 2013, all provisions; H.R. 942/S. 948, Ensuring Access to Quality Complex Rehabilitation Act of 2013, all provisions; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013, all provisions; (see contination page)H.R 27, Small Supplier Fairness in Building Competition Act of 2013, all provisions. H.R. 1717, Medicare DEMPOS Market Pricing Program Act of 2013, all provisions. H.R. 2375, Transparency and Accountability in Medicare Bidding, Act of 2013, all provisions.

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

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare;HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; and S 1546: Protecting Student Athletes from Concussions Act of 2013.

Client expense: $83,875 · Firm income: Not reported

Medicaid Managed Care. Implementation of the Medicaid Community First Allignment of Medicare and Medicaid for dually eligible recipients. Choice Option and Balancing Incentives Program. Preservation of Medicaid as an entitlement program. Access to Rehabilitation in Medicare. Preservatiion of Medicare.Medicaid eligibility changes in the Affordable Care Act. Achieving a Better Life Experience Act legislation, H.R. 647, S. 313. Implementation of the Affordable Care Act, P.L. 111-148 and P.L. 111-192, including Medicaid Health and Long Term Services and Supports provisions. Quality measures for long term services and supports in Medicaid Managed Care and payment alignment initiatives for beneficiaries of both Medicare and Medicaid. Medicare Secondary Payer Futures proposal. Long Term Care Commission. S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, and post accute care issues.

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

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013

Client expense: $165,000 · Firm income: Not reported

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

Support and promote HR 942/S.948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013. This legislation creates a separate benefit for complex rehab technology under Medicare for individuals with significant disabilities and functional limitations.United Spinal discussed CMS' competitive bidding program with CMS and explained United Spinal's main complaints with the program: Difficulty getting wheelchair repairs and delays in wheelchair repair Delivery delays Wrong products/parts delivered Difficulty contacting suppliers and obtaining wheelchairs Supplier locations too far from home In some cases, inferior quality of services and supplies Discussed protecting peoples access to medically necessary medical equipment and related services (HR 1717 - the Medicare DMEPOS Market Pricing Act) and ensure that individuals with disabilities receive high-quality service and equipment that will give our community the ability to live active, productive independent lives with improved health outcomes. Oppose CMS' Medicare Secondary Payer authority that requires current Medicare beneficiaries and non-beneficiaries to project what their future medical needs may be related to the accident, injury or illness in question. Discussed opposition to CMS' DME coding decisions related to K0009 wheelchairs and the issue of seat elevation which is not covered under Medicare. Ensure adequate funding for all Medicaid services, including waiver programs that allow people with disabilities to remain in their homes and contribute to the community. Oppose restructuring of Medicaid funding known as block grants or per capita caps. Support and expand state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option; Money Follows the Person; and the Balancing Incentive Program; and, increase HCBS eligibility such as the Enhanced 1915(i) State Plan Option. Promote state adoption of the Consortium for Citizens with Disabilities (CCD) and National Disability Leadership Alliance (NDLA) Managed Care Principles. Adoption of the principles would ensure consumers transitioning to managed care have access to consumer-directed care and the specialized and supportive services they need to improve their quality of life and remain in the community. Advocate for the creation of state-level ombudsmen for any Medicaid demonstration projects geared toward integrating care for individuals eligible for Medicare and Medicaid. An ombudsman would provide individual assistance, assist with complaints, advocate, and monitor and report on the programs provision of information and services for consumers. Support and fund quality measures (i.e. data collection) that track how well Medicaid programs allow for person-centered and consumer-directed services; timely provision of care; access to necessary services such as housing and employment; and, consumer satisfaction with those services. Discussed Commission on Long-Term Care principles with Commissioners and Congressional offices on the following issues as they relate to long-term care: financing, the role of consumers and family caregivers, quality of life, quality of care and workforce protections. Supports HR 713/S. 367 - Medicare Access to Rehabilitation Services Act - legislation that would repeal the arbitrary cap on outpatient rehabilitation services.We submitted comments to the EEOC regarding the potential of wellness programs to discriminate against our members with spinal cord injuries or diseases (SCI/D) and individuals with other disabilities. Distributed testimony to the House Ways and Means Health Subcommittee as a member of the Coalition to Preserve Rehabilitation highlighting the need to preserv acdess to high-quality rehabiliation in response to various Medicare proposals addressing post-acute care such as site neutral payment proposals which would reduce access significantly to inpatient rehabilitation for patients with different types of SCI; opposition to increasing the 60% rule for inpatient rehabilitation hospitals to 75%. This rule is used to define inpatient rehabilitation facilities (IRF) in order for them to receive payment as an IRF. The rule requires that at least 60 percent of cases an IRF admits have one or more selected conditions such as stroke, spinal cord injury. The testimony also addressed opposition to audit contractors review of claims in excess of $3700 which creates a chilling effect on access to services above the $3700 cap. Support protections for dual-eligible demonstration projects to include the following: transparency, ombudsman programs; financing structure, quality measures. Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities.