Preserving Patient Access to Post-Acute Hospital Care Act of 2015

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule; Support S. 3173 EHR Regulatory Relief Act, a bill to amend title XVIII of the Social Security Act to provide for a 90-day EHR reporting period for the determination of whether an eligible professional or eligible hospital is a meaningful EHR user and to remove the all-or-nothing approach to meaningful use; Support for H.R. 5713, The Sustaining Healthcare Integrity and Fair Treatment Act of 2016, a bill that would extend 25% rule relief and provide targeted relief to certain LTCHs struggling to meet the new criteria standards; Support for H.R. 6174, the Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title.

Client expense: $4,050,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule.

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections) S. 2368 Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (all sections) HR. 2029 Consolidated Appropriations Act, 2016 (Title II, Section 231 - LTAC Wound Criteria; Title V, Section 504 - HH Disposable Devices) HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes S.3107 - A bill to amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) H.R.5559 - To amend section 1206 of the Pathway for SGR Reform Act of 2013 to clarify the application of rules on the calculation of hospital length of stay to certain moratorium-excepted long-term care hospitals (LTCHs) (all sections) H.R.5273 - Helping Hospitals Improve Patient Care Act of 2016 (TITLE 1, (Sec. 104) With respect to long-term care hospitals, the bill lifts a moratorium on bed increases. The bill reduces rates for high-cost outlier payments, which are additional Medicare payments made in extraordinarily high-cost cases.) HR 5688 - To amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) S.3096 - Removing Barriers to Person-Centered Care Act of 2016 (all sections) S. 3130 - Independence at Home Act of 2016 (all sections) HR 34 - 21st Century CURES Act, Title XV - Provisions Relating to Medicare Part A (Sec. 15004. Regulatory relief for LTCHs, Sec. 15006. Extension of certain LTCH Medicare payment rules, and Sec. 15007. Application of rules on the calculation of hospital length of stay to all LTCHs)

Post Acute Care Payment Reform, Home Health Prior Authorization Requirements, H.R. 441-To provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 202-A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, Value Based Purchasing, Long term acute care hospital reimbursements, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015, 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, S. 202- A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 2108-A bill to amend title XVIII of the Social Security Act to provide for an extension of certain long-term care hospital payment rules and the moratorium on the establishment of certain hospitals and facilities., H.R. 5273-Helping Hospitals Improve Patient Care Act of 2016, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015

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

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act HR 6226 - Pre-Claims Undermine Seniors Health Act S. 2108 - Preserving Patient Access to Post-Acute Hospital Care Act H.R. 4725 - Common Sense Savings Act of 2016 Implementation of PL 113-185 - Impact Act of 2014 Post acute payment and reform issues. CMS home health pre-claim review demonstration H.R. 6 - 21st Century Cures Act

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

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

Socioeconomic adjustment of the hospital readmission reduction program (H.R. 1343/S. 688, H.R. 5273/H.R. 34 - 21st Century Cures Act) Medicare audit contractor program reforms (H.R. 2156, S. 2368) Rural hospital policies (H.R. 663 / S. 332, H.R. 169/S. 258, H.R. 1611/S. 257, S. 1461/H.R. 2878, H.R. 5164, H.R. 5613, CAH cost-based reimbursement) Telehealth, interoperability, health information technology (H.R. 6/H.R. 34 - 21st Century Cures Act, S. 2511, S. 2484/H.R. 4442) Post-Acute Care policies (H.R. 3298), home health prior authorization S. 2108, H.R. 5713 Health Care and Medicaid financing reform (Better Way white paper, Empowering Patients First Act, Patient CARE Act, H.R. 5284/S. 2985) Graduate Medical Education policy (H.R. 2124, S. 1148, H.R 3292, H.R. 6333) HR 976, HR 2513 DSH payment Bundled payment programs Clinical lab payment policy MACRA implementation NOTICE Act implementation Sec 603 Bipartisan Budget Act / site neutral payment policies (H.R. 5273/H.R. 34 - 21st Century Cures Act) Stark Law reforms H.R. 4428, H.R. 6399 Star Ratings Medicare Part B drug payment model Medicare Advantage policy

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

Issues related to Medicare payment for Long Term Care Hospitals; Issues concerning H.R. 2580 the LTCH Technical Correction Act of 2015 Issues related to S. 2108 Preserving Patient Access to Post-Acute Hospital Care Act of 2015 H.R. 5713 the Sustaining Healthcare Integrity and Fair Treatment (SHIFT) Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule; Support S. 3173 EHR Regulatory Relief Act, a bill to amend title XVIII of the Social Security Act to provide for a 90-day EHR reporting period for the determination of whether an eligible professional or eligible hospital is a meaningful EHR user and to remove the all-or-nothing approach to meaningful use; Support for H.R. 5713, The Sustaining Healthcare Integrity and Fair Treatment Act of 2016, a bill that would extend 25% rule relief and provide targeted relief to certain LTCHs struggling to meet the new criteria standards; Support for H.R. 6174, the Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title.

H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015; H.R. 1343/S. 688, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015; H.R. 1526, Medicare Audit Improvement Act of 2015; Medicare and Medicaid reimbursement; CMS/HHS on health insurance marketplace; S. 298/H.R. 546, ACE Kids Act; Helping Hospitals Improve Patient Care Act (H.R. 5273; Preserving Patient Access to Post-Acute Hospital Care Act (H.R. 4650/S. 2108); 21st Century Cures Act (H.R. 34).

Client expense: Not reported · Firm income: $100,000

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections) S. 2368 Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (all sections) HR. 2029 Consolidated Appropriations Act, 2016 (Title II, Section 231 - LTAC Wound Criteria; Title V, Section 504 - HH Disposable Devices) HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes S.3107 - A bill to amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) H.R.5559 - To amend section 1206 of the Pathway for SGR Reform Act of 2013 to clarify the application of rules on the calculation of hospital length of stay to certain moratorium-excepted long-term care hospitals (LTCHs) (all sections) H.R.5273 - Helping Hospitals Improve Patient Care Act of 2016 (TITLE 1, (Sec. 104) With respect to long-term care hospitals, the bill lifts a moratorium on bed increases. The bill reduces rates for high-cost outlier payments, which are additional Medicare payments made in extraordinarily high-cost cases.) HR 5688 - To amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) S.3096 - Removing Barriers to Person-Centered Care Act of 2016 (all sections) S. 3130 - Independence at Home Act of 2016 (all sections) HR 34 - 21st Century CURES Act, Title XV - Provisions Relating to Medicare Part A (Sec. 15004. Regulatory relief for LTCHs, Sec. 15006. Extension of certain LTCH Medicare payment rules, and Sec. 15007. Application of rules on the calculation of hospital length of stay to all LTCHs)

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule; Support S. 3173 EHR Regulatory Relief Act, a bill to amend title XVIII of the Social Security Act to provide for a 90-day EHR reporting period for the determination of whether an eligible professional or eligible hospital is a meaningful EHR user and to remove the all-or-nothing approach to meaningful use; Support for H.R. 5713, The Sustaining Healthcare Integrity and Fair Treatment Act of 2016, a bill that would extend 25% rule relief and provide targeted relief to certain LTCHs struggling to meet the new criteria standards; Support for H.R. 6174, the Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title.

Issues related to Medicare payment for Long Term Care Hospitals; Issues concerning H.R. 2580 the LTCH Technical Correction Act of 2015 Issues related to S. 2108 Preserving Patient Access to Post-Acute Hospital Care Act of 2015 H.R. 5713 the Sustaining Healthcare Integrity and Fair Treatment (SHIFT) Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Two Midnight Rule Socioeconomic adjustment of the hospital readmission reduction program (H.R. 1343/S. 688, H.R. 5273) Medicare audit contractor program reforms (H.R. 2156, S. 2368) Rural hospital policies (H.R. 663 / S. 332, H.R. 169/S. 258, H.R. 1611/S. 257, S. 1461/H.R. 2878, H.R. 5164, H.R. 5613, CAH cost-based reimbursement) Telehealth, interoperability, health information technology (H.R. 6, S. 2511, S. 2484/H.R. 4442) Post-Acute Care policies (H.R. 3298), home health prior authorization S. 2108, H.R. 5713 Graduate Medical Education policy (H.R. 2124, S. 1148, H.R 3292) HR 976, HR 2513 DSH payment Bundled payment programs Clinical lab payment policy MACRA implementation NOTICE Act implementation Sec 603 Bipartisan Budget Act / site neutral payment policies (H.R. 5273) Stark Law reforms H.R. 4428 Star Ratings Medicare Part B drug payment model Medicare Advantage

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act HR 6226 - Pre-Claims Undermine Seniors Health Act S. 2108 - Preserving Patient Access to Post-Acute Hospital Care Act S. 3107 - a bill to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals H.R. 4725 - Common Sense Savings Act of 2016 Implementation of PL 113-185 - Impact Act of 2014 Post acute payment and reform issues. CMS home health pre-claim review demonstration

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

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

CMS Post-Acute Care regulatory reform related issues H.R.4650/S.2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, Post Acute Care regulatory reform issues H.R.5713, Sustaining Healthcare Integrity and Fair Treatment Act of 2016, Post Acute Care regulatory reform issues Monitor the following: H.R.2646, Helping Families in Mental Health Crisis Act of 2015, Psychiatric workforce issues S.1945, Mental Health Reform Act of 2015, Psychiatric workforce issues Medicare Access & CHIP Reauthorization Act (MACRA) implementation

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015; H.R. 1343/S. 688, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015; H.R. 1526, Medicare Audit Improvement Act of 2015; Medicare and Medicaid reimbursement; CMS/HHS on health insurance marketplace; S. 298/H.R. 546, ACE Kids Act; Helping Hospitals Improve Patient Care Act (H.R. 5273; Preserving Patient Access to Post-Acute Hospital Care Act (H.R. 4650/S. 2108).

Client expense: Not reported · Firm income: $100,000

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

Post Acute Care Payment Reform, Home Health Prior Authorization Requirements, H.R. 441-To provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 202-A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, Value Based Purchasing, Long term acute care hospital reimbursements, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015, 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, S. 202- A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 2108-A bill to amend title XVIII of the Social Security Act to provide for an extension of certain long-term care hospital payment rules and the moratorium on the establishment of certain hospitals and facilities., H.R. 5273-Helping Hospitals Improve Patient Care Act of 2016, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections) S. 2368 Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (all sections) HR. 2029 Consolidated Appropriations Act, 2016 (Title II, Section 231 - LTAC Wound Criteria; Title V, Section 504 - HH Disposable Devices) HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes S.3107 - A bill to amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) H.R.5559 - To amend section 1206 of the Pathway for SGR Reform Act of 2013 to clarify the application of rules on the calculation of hospital length of stay to certain moratorium-excepted long-term care hospitals (LTCHs) (all sections) H.R.5273 - Helping Hospitals Improve Patient Care Act of 2016 (TITLE 1, (Sec. 104) With respect to long-term care hospitals, the bill lifts a moratorium on bed increases. The bill reduces rates for high-cost outlier payments, which are additional Medicare payments made in extraordinarily high-cost cases.) HR 5688 - To amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) S.3096 - Removing Barriers to Person-Centered Care Act of 2016 (all sections) S. 3130 - Independence at Home Act of 2016 (all sections)

Issues related to Medicare payment for Long Term Care Hospitals; Issues concerning H.R. 2580 the LTCH Technical Correction Act of 2015 Issues related to S. 2108 Preserving Patient Access to Post-Acute Hospital Care Act of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule.

Post acute care issues. S. 2108, Preserving Access to Post-Acute Hospital Care Act of 2015. Medicaid Provider Assessment. Home Health Prior Authorization Demonstration. Chronic Care Initiative.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Post Acute Care Payment Reform, Home Health Prior Authorization Requirements, H.R. 441-To provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 202-A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, Value Based Purchasing, Long term acute care hospital reimbursements, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015, 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, S. 202- A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 2108-A bill to amend title XVIII of the Social Security Act to provide for an extension of certain long-term care hospital payment rules and the moratorium on the establishment of certain hospitals and facilities., H.R. 5273-Helping Hospitals Improve Patient Care Act of 2016

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

H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015; H.R. 1343/S. 688, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015; H.R. 1526, Medicare Audit Improvement Act of 2015; Medicare and Medicaid reimbursement; CMS/HHS on health insurance marketplace; S. 298/H.R. 546, ACE Kids Act; Helping Hospitals Improve Patient Care Act (H.R. 5273; Preserving Patient Access to Post-Acute Hospital Care Act (H.R. 4650/S. 2108).

Client expense: Not reported · Firm income: $100,000

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections) S. 2368 Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (all sections) HR. 2029 Consolidated Appropriations Act, 2016 (Title II, Section 231 - LTAC Wound Criteria; Title V, Section 504 - HH Disposable Devices) HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes HR 4725 Common Sense Savings Act of 2016 - Section 4, Extending previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes S.3107 - A bill to amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals (all sections) H.R.5559 - To amend section 1206 of the Pathway for SGR Reform Act of 2013 to clarify the application of rules on the calculation of hospital length of stay to certain moratorium-excepted long-term care hospitals (LTCHs) (all sections) H.R.5273 - Helping Hospitals Improve Patient Care Act of 2016 (TITLE 1, (Sec. 104) With respect to long-term care hospitals, the bill lifts a moratorium on bed increases. The bill reduces rates for high-cost outlier payments, which are additional Medicare payments made in extraordinarily high-cost cases.) S.3096 - Removing Barriers to Person-Centered Care Act of 2016 (all sections)

- HR 1250/S 1211- 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 - Patient criteria for long-term care hospitals - The Improving Medicare Post-Acute Care Transformation Act of 2014 or IMPACT Act of 2014 (H.R. 4994) - S.2108 - A bill to amend title XVIII of the Social Security Act to provide for an extension of certain long-term care hospital payment rules and the moratorium on the establishment of certain hospitals and facilities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Post acute care issues. S. 2108, Preserving Access to Post-Acute Hospital Care Act of 2015. Medicaid Provider Assessment. Home Health Prior Authorization Demonstration. Chronic Care Initiative.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis;Spoke with Rep. Kinds office on legislation to address the opioid epidemic in America; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Comments on Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care.

Post Acute Care Payment Reform, Home Health Reimbursements, H.R. 441-To provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 202-A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, Value Based Purchasing, Long term acute care hospital reimbursements, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015, 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, S. 202- A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 2108-A bill to amend title XVIII of the Social Security Act to provide for an extension of certain long-term care hospital payment rules and the moratorium on the establishment of certain hospitals and facilities.

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections) S. 2368 Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (all sections) HR. 2029 Consolidated Appropriations Act, 2016 (Title II, Section 231 - LTAC Wound Criteria; Title V, Section 504 - HH Disposable Devices) HR. 4725 Common Sense Savings Act of 2016 - Section 4, Extending Previous Medicaid Threshold Applied for Determining Acceptable Provider Taxes

Client expense: $627,000 · Firm income: Not reported

S. 2108, Preserving Access to Post-Acute Hospital Care Act of 2015 H.R. 1250/S. 1211, Temporary exception to site neutral payment rate for certain discharges involving severe wounds S. 202, Technical change to the Medicare Long-Term Care Hospital moratorium exception H.R. 441, To provide for a technical change to the Medicare long-term care hospital moratorium exception.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Post Acute Care Payment Reform, Home Health Reimbursements, Medicare Sequester, H.R. 441-To provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 202-A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, Value Based Purchasing, Long term acute care hospital reimbursements, H.R. 3298-Medicare Post-Acute Care Value-Based Purchasing Act of 2015, H.R. 2029-Consolidated Appropriations Act, 2016, 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, S. 202- A bill to provide for a technical change to the Medicare long-term care hospital moratorium exception, S. 2108-A bill to amend title XVIII of the Social Security Act to provide for an extension of certain long-term care hospital payment rules and the moratorium on the establishment of certain hospitals and facilities.

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections) S. 2368 Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (all sections) HR. 2029 Consolidated Appropriations Act, 2016 (Title II, Section 231 - LTAC Wound Criteria; Title V, Section 504 - HH Disposable Devices)

Client expense: $543,000 · Firm income: Not reported

H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S. 2108, Preserving Access to Post-Acute Hospital Care Act of 2015 H.R. 1250/S. 1211, Temporary exception to site neutral payment rate for certain discharges involving severe wounds S. 202, Technical change to the Medicare Long-Term Care Hospital moratorium exception H.R. 1458, BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 H.R. 3037, Hospice Care Access Improvement Act of 2015 H.R. 2196, Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015 S. 1650, Home Health Documentation and Program Improvement Act of 2015

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) S 2108 Preserving Access to Post-Acute Hospital Care Act of 2015 (all sections) S 1211 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) HR 1250 Temporary exception to site neutral payment rate for certain discharges involving severe wounds (all sections) S 202 Technical change to the Medicare Long-Term Care Hospital moratorium exception (all sections) HR 1458 BACPAC (Bundling and Coordinating Post-Acute Care) Act of 2015 (all sections) HR 3037 Hospice Care Access Improvement Act of 2015 (all sections) HR 2196 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) HR 2 Medicare Access and CHIP Reauthorization Act of 2015 (Title II, Sec 202 - Therapy Cap Exceptions Process; Title IV, Sec 411 - PAC pay for; Title V, Sec 513 - Home health surety bond) S. 1650 Home Health Documentation and Program Improvement Act of 2015 (all sections

Client expense: $326,000 · Firm income: Not reported

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