Medicare Choices Empowerment and Protection Act

Discussed importance of high-quality electronic advance medical directives (ADs) for all adults over 18 years old that can be accessed 24 hrs/day, 7 days/week by patients, physicians, and hospitals anywhere in the world as part of the patient's electronic health record (EHR). Seeking consideration of ADs as a core requirement under the Stage 3 Meaningful Use Rule, as recommended by the HIT Policy Committee, Joint Commission, and the National Quality Forum (NQF). Proposals considered to incentivize all Medicare / Medicaid beneficiaries as well as all federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 2297 / HR 4059), introduced by Senators Coons / Cassidy & Reps Black, Thompson, Welch, and Collins. Legislation provides a one-time financial incentive to Medicare beneficiaries for voluntarily registering an advance care plan (ACP).

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

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

Encouraging the adoption of digital advance care plans S.2297; HR.4059-- Medicare Choices Empowerment and Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussed importance of high-quality electronic advance medical directives (ADs) for all adults over 18 years old that can be accessed 24 hrs/day, 7 days/week by patients, physicians, and hospitals anywhere in the world as part of the patient's electronic health record (EHR). Seeking consideration of ADs as a core requirement under the Stage 3 Meaningful Use Rule, as recommended by the HIT Policy Committee, Joint Commission, and the National Quality Forum (NQF). Proposals considered to incentivize all Medicare / Medicaid beneficiaries as well as all federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 2297 / HR 4059), introduced by Senators Coons / Cassidy & Reps Black, Thompson, Welch, and Collins. Legislation provides a one-time financial incentive to Medicare beneficiaries for voluntarily registering an advance care plan (ACP).

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

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

Contacts in support of repealing the Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would 1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 5) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts regarding S. 1549, the Care Planning Act of 2015 because 1) it fails to contain proper safeguards against dissuading patients to reject life-saving treatment they would otherwise want both to cut costs, and also due to a pervasive quality of life ethic 2) it authorizes health care providers to deny life-preserving treatment against the express will of a patient or surrogate invalidating several state protective laws and 3) advance planning documents that may have been filled out in other states are to be implemented removing state power over informed consent requirements surrounding choosing life-saving measures, food and fluids. Contacts in the U.S. Senate in support of S.2297, the Medicare Choices Empowerment and Protection Act, which would give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts in the U.S. House in support of H.R. 4059, the Medicare Choices Empowerment and Protection Act, which would give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts regarding advance care planning legislation (not introduced) 1) ensure the legislation provides for adequate oversight regarding the creation of advance planning materials, websites, etc. in order to protect against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, 2) ensure that there are not Federally funded unmonitored practitioner consultations could lead to patients forgoing treatment they would otherwise have wanted, 3) ensure that there are not adverse changes to the Assisted Suicide Funding and Restriction Act 4) include oversight for grant approval for physician orders for life-sustaining treatment and 5) protect the right of states to ensure informed consent in choosing and rejecting treatment. Contacts regarding legislation (not introduced) regarding the Patient Protection and Affordable Care Act, Public Law 111-148, provision related to the excise tax on employer-paid health insurance premiums above a governmentally-imposed limit that does not allow for medical inflation because the excess benefits tax will have its intended result of effectively imposing a price control on health insurance premiums. Contacts in the U.S. House in support of H.R. 3251 which would prohibit the coverage of advance care planning services under the Medicare Program because unmonitored advance care planning services can in practice be used to nudge patients to agree to forego life-saving treatment and even assisted feeding through the use of unbalanced, distorted, and even inaccurate information. Contacts regarding H.R. 3119, the "Palliative Care and Hospice Education and Training Act" as to whether provisions of the Assisted Suicide Funding Restriction Act would be revoked. Contacts regarding legislation (not introduced) regarding potential legislation related to strengthening Federal policy against physician assisted suicide. Contacts in the U.S. House regarding potential CMS action in regards to the advance care planning services that have been recently added to the list of services in the Physician Fee Schedule payment rule.

Encouraging the adoption of digital advance care plans S.2297; HR.4059-- Medicare Choices Empowerment and Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.953-Comprehensive Addiction and Recovery Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1641-Jason Simcakoski Memorial Opioid Safety Act H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2366-Field EMS Modernization and Innovation Act H.R.2463-Dispose Responsibly of your Pills (DROP) Act of 2015 H.R.2536-Recovery Enhancement for Addiction Treatment (TREAT) Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2805-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.2872-Opioid Addiction Treatment Modernization Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3014-Medical Controlled Substances Transportation Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3250-DXM Abuse Prevention Act of 2015 H.R.3299-Strengthening Public Health Emergency Response Act H.R.3537-Synthetic Drug Control Act of 2015 H.R.3677-Opioid Abuse Prevention and Treatment Act of 2015 H.R.3680-Co-Prescribing to Reduce Overdose Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3691-Improving Treatment for Pregnant and Postpartum Women Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.3865-Cradle Act H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4063-Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act H.R.4365-Protecting Patient Access to Emergency Medications Act of 2016 H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.4447-Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act H.R.4499-Promoting Responsible Opioid Prescribing Act of 2016 H.R.4599-Reducing Unused Medications Act of 2016 H.R.4641-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, and for other purposes. H.R.4697-Prevevent Drug Addiction Act of 2016 H.R.4771-Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R.4732-Advancing Medical Resident Training in Community Hospitals Act of 2016 H.R.5243-Zika Response Appropriations Act H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.524-Comprehensive Addiction and Recovery Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.636-Increasing the Safety of Prescription Drug Use Act of 2015 S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.954-FDA Accountability for Public Safety Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1134-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 S.1392-Safer Prescribing of Controlled Substances Act S.1410-Treatment and Recovery Investment Act S.1431-Prescription Drug Abuse Prevention and Treatment Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1455-Recovery Enhancement for Addiction Treatment Act S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2256-Co-Prescribing Saves Lives Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2562-Heroin and Prescription Drug Abuse Prevention and Reduction Act S.2567-Preventing Overprescribing for Pain Act of 2016 S.2578-Reducing Unused Medications Act of 2016 S.2597-Medicare Mental Health Access Act S.2671-Advancing Medical Resident Training in Community Hospitals Act of 2016 S.2680-Mental Health Reform Act of 2016 S.2687-Plan of Safe Care Improvement Act S.2932-Protecting Patient Access to Emergency Medications Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016 P.L.114-10-Medicare Access and CHIP Reauthorization Act of 2015

H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3288-Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 H.R.3291-Medicare Crosswalk Hospital Code Development Act of 2015 H.R.3292-Medicare IME Pool Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.843-Improving Access to Medicare Coverage Act of 2015 S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2680-Mental Health Reform Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016 P.L.114-10-Medicare Access and CHIP Reauthorization Act of 2015

Client expense: $512,329 · Firm income: Not reported

Discussed importance of high-quality electronic advance medical directives (ADs) for all adults over 18 years old that can be accessed 24 hrs/day, 7 days/week by patients, physicians, and hospitals anywhere in the world as part of the patient's electronic health record (EHR). Seeking consideration of ADs as a core requirement under the Stage 3 Meaningful Use Rule, as recommended by the HIT Policy Committee, Joint Commission, and the National Quality Forum (NQF). Proposals considered to incentivize all Medicare / Medicaid beneficiaries as well as all federal employees through FEHBP to create and store a digital AD. Endorsed legislation (S. 2297/ H.R. 4059), sponsored by Senator Coons & Rep. Black, that provides an incentive to Medicare beneficiaries for voluntarily registering an AD.

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

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

H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3288-Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 H.R.3291-Medicare Crosswalk Hospital Code Development Act of 2015 H.R.3292-Medicare IME Pool Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.843-Improving Access to Medicare Coverage Act of 2015 S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2680-Mental Health Reform Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016

Client expense: $217,135 · Firm income: Not reported

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.953-Comprehensive Addiction and Recovery Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1641-Jason Simcakoski Memorial Opioid Safety Act H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2366-Field EMS Modernization and Innovation Act H.R.2463-Dispose Responsibly of your Pills (DROP) Act of 2015 H.R.2536-Recovery Enhancement for Addiction Treatment (TREAT) Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2805-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.2872-Opioid Addiction Treatment Modernization Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3014-Medical Controlled Substances Transportation Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3250-DXM Abuse Prevention Act of 2015 H.R.3299-Strengthening Public Health Emergency Response Act H.R.3537-Synthetic Drug Control Act of 2015 H.R.3677-Opioid Abuse Prevention and Treatment Act of 2015 H.R.3680-Co-Prescribing to Reduce Overdose Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3691-Improving Treatment for Pregnant and Postpartum Women Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.3865-Cradle Act H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4063-Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act H.R.4365-Protecting Patient Access to Emergency Medications Act of 2016 H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.4447-Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act H.R.4499-Promoting Responsible Opioid Prescribing Act of 2016 H.R.4599-Reducing Unused Medications Act of 2016 H.R.4641-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, and for other purposes. H.R.4697-Prevevent Drug Addiction Act of 2016 H.R.4771-Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R.4732-Advancing Medical Resident Training in Community Hospitals Act of 2016 H.R.5243-Zika Response Appropriations Act H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.524-Comprehensive Addiction and Recovery Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.636-Increasing the Safety of Prescription Drug Use Act of 2015 S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.954-FDA Accountability for Public Safety Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1134-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 S.1392-Safer Prescribing of Controlled Substances Act S.1410-Treatment and Recovery Investment Act S.1431-Prescription Drug Abuse Prevention and Treatment Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1455-Recovery Enhancement for Addiction Treatment Act S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2256-Co-Prescribing Saves Lives Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2562-Heroin and Prescription Drug Abuse Prevention and Reduction Act S.2567-Preventing Overprescribing for Pain Act of 2016 S.2578-Reducing Unused Medications Act of 2016 S.2597-Medicare Mental Health Access Act S.2671-Advancing Medical Resident Training in Community Hospitals Act of 2016 S.2680-Mental Health Reform Act of 2016 S.2687-Plan of Safe Care Improvement Act S.2932-Protecting Patient Access to Emergency Medications Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016

Contacts in support of repealing the Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would 1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an "excessive or unjustified" amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to "shared decisionmaking" because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts regarding S. 1549, the Care Planning Act of 2015 because 1) it fails to contain proper safeguards against dissuading patients to reject life-saving treatment they would otherwise want both to cut costs, and also due to a pervasive quality of life ethic 2) it authorizes health care providers to deny life-preserving treatment against the express will of a patient or surrogate invalidating several state protective laws and 3) advance planning documents that may have been filled out in other states are to be implemented removing state power over informed consent requirements surrounding choosing life-saving measures, food and fluids. Contacts in the U.S. Senate in support of S.2297, the Medicare Choices Empowerment and Protection Act, which would Give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts in the U.S. House in support of H.R. 4059, the Medicare Choices Empowerment and Protection Act, which would Give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts regarding advance care planning legislation (not introduced) 1) ensure the legislation provides for adequate oversight regarding the creation of advance planning materials, websites, etc. in order to protect against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, 2) ensure that there are not Federally funded unmonitored practitioner consultations could lead to patients forgoing treatment they would otherwise have wanted, 3) ensure that there are not adverse changes to the Assisted Suicide Funding and Restriction Act 4) include oversight for grant approval for physician orders for life-sustaining treatment and 5) protect the right of states to ensure informed consent in choosing and rejecting treatment. Contacts regarding legislation (not introduced) regarding the Patient Protection and Affordable Care Act, Public Law 111-148, provision related to the excise tax on employer-paid health insurance premiums above a governmentally imposed limit that does not allow for medical inflation because the excess benefits tax will have its intended result of effectively imposing a price control on health insurance premiums. Contacts in the U.S. House in support of H.R. 3251 which would prohibit the coverage of advance care planning services under the Medicare Program because unmonitored advance care planning services can in practice be used to nudge patients to agree to forego life-saving treatment and even assisted feeding through the use of unbalanced, distorted, and even inaccurate information. Contacts regarding H.R. 3119, the "Palliative Care and Hospice Education and Training Act" as to whether provisions of the Assisted Suicide Funding Restriction Act would be revoked.

Encouraging the adoption of digital advance care plans S.2297; HR.4059-- Medicare Choices Empowerment and Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussed importance of high-quality electronic advance medical directives (ADs) for all adults over 18 years old that can be accessed 24 hrs/day, 7 days/week by patients, physicians, and hospitals anywhere in the world as part of the patient's electronic health record (EHR). Seeking consideration of ADs as a core requirement under the Stage 3 Meaningful Use Rule, as recommended by the HIT Policy Committee, Joint Commission, and the National Quality Forum (NQF). Proposals considered to incentivize all Medicare / Medicaid beneficiaries as well as all federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 2297 / HR 4059), introduced by Senators Coons / Cassidy & Reps Black, Thompson, Welch, and Collins. Legislation provides a one-time financial incentive to Medicare beneficiaries for voluntarily registering an advance care plan (ACP).

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

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

Contacts in support of repealing the Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would 1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts regarding S. 1549, the Care Planning Act of 2015 because 1) it fails to contain proper safeguards against dissuading patients to reject life-saving treatment they would otherwise want both to cut costs, and also due to a pervasive quality of life ethic 2) it authorizes health care providers to deny life-preserving treatment against the express will of a patient or surrogate invalidating several state protective laws and 3) advance planning documents that may have been filled out in other states are to be implemented removing state power over informed consent requirements surrounding choosing life-saving measures, food and fluids. Contacts in the U.S. Senate in support of S.2297, the Medicare Choices Empowerment and Protection Act, which would Give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts in the U.S. House in support of H.R. 4059, the Medicare Choices Empowerment and Protection Act, which would give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts regarding advance care planning legislation (not introduced) 1) ensure the legislation provides for adequate oversight regarding the creation of advance planning materials, websites, etc. in order to protect against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, 2) ensure that there are not Federally funded unmonitored practitioner consultations could lead to patients forgoing treatment they would otherwise have wanted, 3) ensure that there are not adverse changes to the Assisted Suicide Funding and Restriction Act 4) include oversight for grant approval for physician orders for life-sustaining treatment and 5) protect the right of states to ensure informed consent in choosing and rejecting treatment. Contacts regarding legislation (not introduced) regarding the Patient Protection and Affordable Care Act, Public Law 111-148, provision related to the excise tax on employer-paid health insurance premiums above a governmentally imposed limit that does not allow for medical inflation because the excess benefits tax will have its intended result of effectively imposing a price control on health insurance premiums. Contacts in the U.S. House in support of H.R. 3251 which would prohibit the coverage of advance care planning services under the Medicare Program because unmonitored advance care planning services can in practice be used to nudge patients to agree to forego life-saving treatment and even assisted feeding through the use of unbalanced, distorted, and even inaccurate information. Contacts regarding H.R. 3119, the "Palliative Care and Hospice Education and Training Act" as to whether provisions of the Assisted Suicide Funding Restriction Act would be revoked.

Responded to inquiry regarding in-home supportive services programs. (no bill #) S. 1549, Care Planning Act - Discussed the bill and urged cosponsorship. Discussed structural changes to Medicaid. (no bill #) Discussed health care quality and measurement. (no bill #) Discussed changes to the Medicare benefit design, such as copays, premiums and deductibles. (no bill #) Discussed Personalize Your Care Act and provided feedback. (no bill #) Discussed Money Follows the Person Rebalancing Demonstration. (no bill #) Made inquiry regarding DC Medicaid HCBS waiver. (no bill #) S. 1085, Military and Veteran Caregiver Services Improvement Act - Discussed bill. H.R. 4878, Better Care Lower Cost Act - Discussed bill. Discussed spousal impoverishment in Medicaid. (no bill #) H.R. 4059, S.2297, Medicare Choices Empowerment and Protection Act - Provided feedback on bill. H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act - Discussed feedback and next steps. (no bill #) Inquired regarding final rule on discharge planning. (no bill #) H.R.1571, Improving Access to Medicare Coverage Act - Discussed bill. Discussed retroactive eligibility for Medicaid HCBS (no bill #) Discussed observations status issues. (no bill #) S.578, Home Health Planning Improvement Act - Discussed bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. (no bill #) H.R.2005, S.1083 - Discussed legislation to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 2624, S.1488, Part D Beneficiary Appeals Fairness Act- Discussed bill that would allow seniors to appeal the placement of their medications on a Medicare Part D specialty tier. Discussed Medicare Part D fraud and abuse legislation including lock-in provisions for high risk enrollees. (no bill #) Discussed legislation to require the addition of unique device identifier (UDI) of medical devices in health insurance claim forms. Discussed the Medicare Part B prescription drug demonstration proposal from the Centers for Medicare and Medicaid Services. H.R.1220, S.624, Removing Barriers to Colorectal Cancer Screening Act - Discussed bill. Discussed Medicare site of service payment policy. (no bill #) H.R. 4442,S.2484,CONNECT Act - Sent letter of endorsement. Discussed Medicare coverage and reimbursement of cataract surgery. Labor, Health and Human Services,FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. (no bill #)

Encouraging the adoption of digital advance care plans S.2297; HR.4059-- Medicare Choices Empowerment and Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3288-Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 H.R.3291-Medicare Crosswalk Hospital Code Development Act of 2015 H.R.3292-Medicare IME Pool Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.843-Improving Access to Medicare Coverage Act of 2015 S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2680-Mental Health Reform Act of 2016

Client expense: $661,366 · Firm income: Not reported

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.953-Comprehensive Addiction and Recovery Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1641-Jason Simcakoski Memorial Opioid Safety Act H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2366-Field EMS Modernization and Innovation Act H.R.2463-Dispose Responsibly of your Pills (DROP) Act of 2015 H.R.2536-Recovery Enhancement for Addiction Treatment (TREAT) Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2805-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.2872-Opioid Addiction Treatment Modernization Act H.R.3014-Medical Controlled Substances Transportation Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3250-DXM Abuse Prevention Act of 2015 H.R.3379-Airplane Kids In Transit Safety (KITS) Act of 2015 H.R.3537-Synthetic Drug Control Act of 2015 H.R.3677-Opioid Abuse Prevention and Treatment Act of 2015 H.R.3680-Co-Prescribing to Reduce Overdose Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3691-Improving Treatment for Pregnant and Postpartum Women Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.3865-Cradle Act H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4063-Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act H.R.4365-Protecting Patient Access to Emergency Medications Act of 2016 H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.4447-Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act H.R.4499-Promoting Responsible Opioid Prescribing Act of 2016 H.R.4599-Reducing Unused Medications Act of 2016 H.R.4641-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, and for other purposes. H.R.4697-Prevevent Drug Addiction Act of 2016 H.R.4771-Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.524-Comprehensive Addiction and Recovery Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.636-Increasing the Safety of Prescription Drug Use Act of 2015 S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.954-FDA Accountability for Public Safety Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1134-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 S.1392-Safer Prescribing of Controlled Substances Act S.1410-Treatment and Recovery Investment Act S.1431-Prescription Drug Abuse Prevention and Treatment Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1455-Recovery Enhancement for Addiction Treatment Act S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2256-Co-Prescribing Saves Lives Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2562-Heroin and Prescription Drug Abuse Prevention and Reduction Act S.2567-Preventing Overprescribing for Pain Act of 2016 S.2578-Reducing Unused Medications Act of 2016 S.2597-Medicare Mental Health Access Act S.2680-Mental Health Reform Act of 2016 S.2687-Plan of Safe Care Improvement Act

Contacts in support of repealing the Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would 1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts regarding S. 1549, the Care Planning Act of 2015 because 1)it fails to contain proper safeguards against dissuading patients to reject life-saving treatment they would otherwise want both to cut costs, and also due to a pervasive quality of life ethic 2) it authorizes health care providers to deny life-preserving treatment against the express will of a patient or surrogate invalidating several state protective laws and 3) advance planning documents that may have been filled out in other states are to be implemented removing state power over informed consent requirements surrounding choosing life-saving measures, food and fluids. Contacts in the U.S. Senate in support of S.2297, the Medicare Choices Empowerment and Protection Act, which would Give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts in the U.S. House in support of H.R. 4059, the Medicare Choices Empowerment and Protection Act, which would Give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. Contacts regarding advance care planning legislation (not introduced) 1) ensure the legislation provides for adequate oversight regarding the creation of advance planning materials, websites, etc. in order to protect against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, 2) ensure that there are not Federally funded unmonitored practitioner consultations could lead to patients forgoing treatment they would otherwise have wanted, 3) ensure that there are not adverse changes to the Assisted Suicide Funding and Restriction Act 4) include oversight for grant approval for physician orders for life-sustaining treatment and 5) protect the right of states to ensure informed consent in choosing and rejecting treatment. Contacts regarding legislation (not introduced) regarding the Patient Protection and Affordable Care Act, Public Law 111-148, provision related to the excise tax on employer-paid health insurance premiums above a governmentally-imposed limit that does not allow for medical inflation because the excess benefits tax will have its intended result of effectively imposing a price control on health insurance premiums. Contacts in the U.S. House in support of H.R. 3251 which would prohibit the coverage of advance care planning services under the Medicare Program because unmonitored advance care planning services can in practice be used to nudge patients to agree to forego life-saving treatment and even assisted feeding through the use of unbalanced, distorted, and even inaccurate information.

H.R. 2005, S. 1083, Medicare Drugs Savings Act, Discussed legislation to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 919, S.522, Childrens's Health Insurance Program - Discussed Children's Health Insurance Program (CHIP) extension. Discussed Medicare coverage of hearing aids. (no bill) Discussed changes to the Medicare benefit design, such as copays, premiums, and deductibles.(no bill) Discussed Medicare health information technology, data transparency, and Qualifying Entities. (no bill) Discussed health care quality and measurement. (no bill) H.R. 2029,H.J.Res.75, H.J.Res.78, Labor, HHS, Education and Related Agencies Appropriations, FY2016 - Lobbied to protect vital health and social services programs, and to prevent repeal of certain financial and healthcare legislation. Discussed structural changes to Medicaid. (no bill) S. 1549, Care Planning Act, Discussed the bill which provides for advanced illness care coordination services. Discussed family caregiver assessment in Medicaid home and community-based services with CMS and guidance to states on the issue.(no bill) Discussed Medicare telemedicine policy. Discussed Medicare Part B premiums and deductibles in 2016. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes (no bill number). Discussed legislation (no bill) to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 2624, S. 1488, Discussed the Part D Beneficiary Appeals Fairness Act, a bill that would allow seniors to appeal the placement of their medications on a Medicare Part D specialty tier. Discussed Medicare Part D fraud and abuse legislation including lock-in provisions for high risk enrollees (no bill). Wrote to CMS in support of the second initiative of Washington State's proposed 1115 waiver. (no bill) S. 1719, Discussed family caregiving, home and community-based services, Money Follows the Person Rebalancing Demonstration, and Balancing Incentives Payments Program. (no bill) Signed onto letter to CMS to request a revision in Medicaid policy to eliminate coverage gaps in home and community-based services in accord with a recent federal court ruling (CMS). (no bill) PL 114-42, Called into NOTICE Act CMS town hall meeting. Discussed Medicaid personal care services in Oregon and California with GAO. (no bill) Discussed Spurring and Environment for Telehealth Innovation Act of 2015. (no bill) Discussed Medicaid managed long-term services and supports in states with GAO. (no bill) Provided feedback on draft Medicare Choices Empowerment and Protection Act (H.R. 4059, S. 2297) and Compassionate Care Act (no bill). H.R. 3298, Provided feedback on Medicare Post-Acute Care Value-Based Purchasing Act. H.R. 2029, Omnibus Appropriations Bill, Talked with Hill staff about possible Medicare Advantage provisions.

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.203-Clay Hunt Suicide Prevention for American Veterans Act H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.876-Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1786-James Zadroga 9/11 Health and Compensation Reauthorization Act H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2366-Field EMS Modernization and Innovation Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3379-Airplane Kids In Transit Safety (KITS) Act of 2015 H.R.3537-Synthetic Drug Control Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.141-Protecting Seniors Access to Medicare Act of 2015 S.167-Clay Hunt Suicide Prevention for American Veterans Act S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.810-SGR Repeal and Medicare Provider Payment Modernization Act of 2015 S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.928-James Zadroga 9/11 Health and Compensation Reauthorization Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act

H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3288-Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 H.R.3291-Medicare Crosswalk Hospital Code Development Act of 2015 H.R.3292-Medicare IME Pool Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act S.141-Protecting Seniors Access to Medicare Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.843-Improving Access to Medicare Coverage Act of 2015 S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act

Client expense: $374,793 · Firm income: Not reported

Encouraging the adoption of digital advance care plans S.2297; HR.4059-- Medicare Choices Empowerment and Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussed importance of high-quality electronic advance medical directives (ADs) for all adults over 18 years old that can be accessed 24 hrs/day, 7 days/week by patients, physicians, and hospitals anywhere in the world as part of the patient's electronic health record (EHR). Seeking consideration of ADs as a core requirement under the Stage 3 Meaningful Use Rule, as recommended by the HIT Policy Committee, Joint Commission, and the National Quality Forum (NQF). Proposals considered to incentivize all Medicare / Medicaid beneficiaries as well as all federal employees through FEHBP to create and store a digital AD. Endorsed legislation (S. 2297/ H.R. 4059), sponsored by Senator Coons & Rep. Black, that provides an incentive to Medicare beneficiaries for voluntarily registering an AD.

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

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