Medicare Access to Rehabilitation Services Act of 2017

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (Division B - Relief for Individuals, Families, and Businesses; Division D - Health Care Response)

Client expense: $520,000 · 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

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018 S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act

Client expense: $980,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections) S. 296 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 2150 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections)

Client expense: $520,000 · 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

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections) S. 296 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 2150 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections)

Client expense: $310,000 · 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

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections) S. 296 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 2150 - Home Health Care Planning Improvement Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing facility value-based purchasing program under the Medicare program)

Client expense: $770,000 · 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

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the implementation of the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the implementation of the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

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

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) S. 433 - Home Health Payment Innovation Act of 2019 (all sections)

Client expense: $560,000 · 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

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Medicare Appeals Procedures) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology HR 7217 Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE ACT) S. 3458: Improvements to Home Health HR 3635: Local Coverage Determination Clarification Act of 2018

Client expense: $252,000 · Firm income: Not reported

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

H.R. 807/S. 253 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) Medicare private contracting H.R. 4133 Medicare Patient Empowerment Act of 2017

Client expense: $252,000 · Firm income: Not reported

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

Support H.R. 741/ S. 243 Rural Hospital Regulatory Relief Act of 2017, a bill that amends title XVIII (Medicare) of the Social Security Act to permanently extend the application by the Centers for Medicare & Medicaid Services of an instruction against the enforcement of certain physician supervision requirements with respect to outpatient therapeutic services in critical access hospitals and small rural hospitals; Support H.R. 807/ S. 253 Medicare Access to Rehabilitation Services Act of 2017, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; Discussion about the Electronic Clinical Quality Measure Reporting: advocating for an extension of the reporting deadline to increase hospitals ability to meet requirements in the Hospital Inpatient Quality Reporting program and the Medicare EHR Incentive Program;Requested clarification from CMS about providing care to justice-involved individuals and receiving Medicaid/Medicare reimbursement for such care to Made efforts in support of clarifying that hospitals may have designated units to care for patients in the custody of law enforcement/correctional institutions and may receive Medicaid reimbursement for care provided in such units; Support S. 872/ HR 1955Rural Hospital Access Act of 2017, a bill to amend title XVIII of the Social Security Act to make permanent the extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support S 1301/ HR 2267, Resident Physician Shortage Reduction Act of 2017, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1628 American Health Care Act / Better Care Reconciliation Act, a bill that would repeal and replace much of the Affordable Care Act, including repealing Medicaid expansion and the advanced premium tax credits for the purchase of coverage on the Health Insurance Marketplaces; Support S 1334/ HR 2797Patient Choices and Quality Care Act of 2017, a bill to provide for advanced illness care coordination services for Medicare beneficiaries; Urged the Administration to cancel Stage 3 of meaningful use by removing the 2018 start date from the regulation. The Administration also should institute a 90- day reporting period in every future year of the program, and gather input from stakeholders on ways to further reduce the burden of the meaningful use program from current requirements; Review S. 1169/ HR 2687, Medicaid Coverage for Addiction Recovery Expansion Act, a bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities; Review HR 2509 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Urged CMS to rescind the 25% Rule and instead rely on the site-neutral payment policy to bring transformative change to the LTCH field; Discussion with CMS about direct supervision of outpatient therapeutic services; Support HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; Discussed with Congress potential offsets to pay for CHIP and other Medicare extender legislation; Support straight extensions of the Medicare-dependent hospital and enhanced low-volume adjustment program; Support eliminating the reductions to Medicaid payments for DSH in fiscal years 2018 and 2019; Urged CMS to eliminate a duplicative budget-neutrality adjustment (BNA) being applied to Medicare payments for LTCH site-neutral cases, an unwarranted 5.1 percent cut. Urged CMS to permanently eliminate the LTCH 25% Rule policy; support The Limited Repeal of the IMD Exclusion for Adult Medicaid Beneficiaries with Substance Use Disorder Act, which would improve access to needed substance use disorder (SUD)treatment services for millions of Americans.

Client expense: $5,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), 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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CNA bill) AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018

Client expense: $970,000 · Firm income: Not reported

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

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 109442: Lifespan Respite Care Act; PL 109365: Older Americans Act Amendments of 2006; PL 111148: The Patient Protection and Affordable Care Act; PL 111152: Affordable Health Care for America Act; PHS 42 USC 254C8: Healthy Start Reauthorization of 2007; PL 111192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111-152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 1628: American Health Care Act of 2017; S 253/HR 807: Medicaid Access to Rehabilitation Services Act of 2017; FY 2017/2018 Labor, Health and Human Services, Education Appropriations; HR 3758/S 1028: Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act (PL 11-119); HR 2824: Increasing Opportunity and Success for Children and Parents through Evidence-Based Home Visiting Act; S 1827/HR 3921: Children's Health Insurance Program (CHIP); S 1829/HR 2824: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program; HR 3778: Direct CARE (Creation, Advancement, and Retention of Employment) Opportunity Act; HR 5306/S 2227: Ensuring Medicaid Provides Opportunities for Widespread Equality, Resources (EMPOWER) Care Act; HR 3493: Care Corps Demonstration Act; HR 6: SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act (PL 115-271); S 1091/HR 3105: Supporting Grandparents Raising Grandchildren Act (PL 115-196); and HR 6157: Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (PL 115-245); S 2227/H 5306: EMPOWER (Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources) Care Act; and HR 7217: Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act.

Client expense: $55,061 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections) S. 2204 - Preserving Rehabilitation Innovation Centers Act of 2017 (all sections)

Client expense: $570,000 · 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

HR 807 and S 253 - legislation regarding rehab therapy spending caps in Medicare; HR 2556 and S 1016 - the CONNECT for Health Act; HR 2550 - the Medicare Telehealth Parity Act; S 787 - the Telehealth Innovation and Improvement Act; and S 431 - the Furthering Access to Stroke Telemedicine Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Medicare Appeals Procedures) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology HR 7217 Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE ACT) S. 3458: Improvements to Home Health HR 3635: Local Coverage Determination Clarification Act of 2018

Client expense: $252,000 · Firm income: Not reported

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

H.R. 807/S. 253 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) Medicare private contracting H.R. 4133 Medicare Patient Empowerment Act of 2017

Client expense: $252,000 · Firm income: Not reported

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

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections)

Client expense: $450,000 · 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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act VA Provider Agreement related language and the VA MISSION Act of 2018 HR 6986, Nursing Home Workforce Act. (CAN bill)

Client expense: $980,000 · Firm income: Not reported

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

Support H.R. 741/ S. 243 Rural Hospital Regulatory Relief Act of 2017, a bill that amends title XVIII (Medicare) of the Social Security Act to permanently extend the application by the Centers for Medicare & Medicaid Services of an instruction against the enforcement of certain physician supervision requirements with respect to outpatient therapeutic services in critical access hospitals and small rural hospitals; Support H.R. 807/ S. 253 Medicare Access to Rehabilitation Services Act of 2017, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; Discussion about the Electronic Clinical Quality Measure Reporting: advocating for an extension of the reporting deadline to increase hospitals ability to meet requirements in the Hospital Inpatient Quality Reporting program and the Medicare EHR Incentive Program;Requested clarification from CMS about providing care to justice-involved individuals and receiving Medicaid/Medicare reimbursement for such care to Made efforts in support of clarifying that hospitals may have designated units to care for patients in the custody of law enforcement/correctional institutions and may receive Medicaid reimbursement for care provided in such units; Support S. 872/ HR 1955Rural Hospital Access Act of 2017, a bill to amend title XVIII of the Social Security Act to make permanent the extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support S 1301/ HR 2267, Resident Physician Shortage Reduction Act of 2017, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1628 American Health Care Act / Better Care Reconciliation Act, a bill that would repeal and replace much of the Affordable Care Act, including repealing Medicaid expansion and the advanced premium tax credits for the purchase of coverage on the Health Insurance Marketplaces; Support S 1334/ HR 2797Patient Choices and Quality Care Act of 2017, a bill to provide for advanced illness care coordination services for Medicare beneficiaries; Urged the Administration to cancel Stage 3 of meaningful use by removing the 2018 start date from the regulation. The Administration also should institute a 90- day reporting period in every future year of the program, and gather input from stakeholders on ways to further reduce the burden of the meaningful use program from current requirements; Review S. 1169/ HR 2687, Medicaid Coverage for Addiction Recovery Expansion Act, a bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities; Review HR 2509 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Urged CMS to rescind the 25% Rule and instead rely on the site-neutral payment policy to bring transformative change to the LTCH field; Discussion with CMS about direct supervision of outpatient therapeutic services; Support HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; Discussed with Congress potential offsets to pay for CHIP and other Medicare extender legislation; Support straight extensions of the Medicare-dependent hospital and enhanced low-volume adjustment program; Support eliminating the reductions to Medicaid payments for DSH in fiscal years 2018 and 2019; Urged CMS to eliminate a duplicative budget-neutrality adjustment (BNA) being applied to Medicare payments for LTCH site-neutral cases, an unwarranted 5.1 percent cut. Urged CMS to permanently eliminate the LTCH 25% Rule policy; support The Limited Repeal of the IMD Exclusion for Adult Medicaid Beneficiaries with Substance Use Disorder Act, which would improve access to needed substance use disorder (SUD)treatment services for millions of Americans.

Client expense: $5,220,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), 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

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

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) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017) H.R.6932 - To amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program (all sections) S.3458 - A bill to amend title XVIII of the Social Security Act to improve home health payment reforms under the Medicare program. (all sections) S.3545 - Home Health Payment Innovation Act of 2018 (all sections)

Client expense: $460,000 · 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

HR 807 and S 253 - legislation regarding rehab therapy spending caps in Medicare; HR 2556 and S 1016 - the CONNECT for Health Act; HR 2550 - the Medicare Telehealth Parity Act; S 787 - the Telehealth Innovation and Improvement Act; and S 431 - the Furthering Access to Stroke Telemedicine Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 109442: Lifespan Respite Care Act; PL 109365: Older Americans Act Amendments of 2006; PL 111148: The Patient Protection and Affordable Care Act; PL 111152: Affordable Health Care for America Act; PHS 42 USC 254C8: Healthy Start Reauthorization of 2007; PL 111192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111-152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 1628: American Health Care Act of 2017; S 253/HR 807: Medicaid Access to Rehabilitation Services Act of 2017; FY 2017/2018 Labor, Health and Human Services, Education Appropriations; HR 3758/S 1028: Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act (PL 11-119); HR 2824: Increasing Opportunity and Success for Children and Parents through Evidence-Based Home Visiting Act; S 1827/HR 3921: Children's Health Insurance Program (CHIP); S 1829/HR 2824: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program; HR 3778: Direct CARE (Creation, Advancement, and Retention of Employment) Opportunity Act; HR 5306/S 2227: Ensuring Medicaid Provides Opportunities for Widespread Equality, Resources (EMPOWER) Care Act; HR 3493: Care Corps Demonstration Act; HR 6: SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act; S 1091/HR 3105: Supporting Grandparents Raising Grandchildren Act (PL 115-196); and HR 6157: Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (PL 115-245); and S 2227/H 5306: EMPOWER (Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources) Care Act.

Client expense: $46,018 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology

Client expense: $251,000 · Firm income: Not reported

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

H.R. 807/S. 253 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) Medicare private contracting H.R. 4133 Medicare Patient Empowerment Act of 2017

Client expense: $251,000 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c).

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

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

American Healthcare Act (H.R. 1628) The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support H.R. 741/ S. 243 Rural Hospital Regulatory Relief Act of 2017, a bill that amends title XVIII (Medicare) of the Social Security Act to permanently extend the application by the Centers for Medicare & Medicaid Services of an instruction against the enforcement of certain physician supervision requirements with respect to outpatient therapeutic services in critical access hospitals and small rural hospitals; Support H.R. 807/ S. 253 Medicare Access to Rehabilitation Services Act of 2017, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; Discussion about the Electronic Clinical Quality Measure Reporting: advocating for an extension of the reporting deadline to increase hospitals ability to meet requirements in the Hospital Inpatient Quality Reporting program and the Medicare EHR Incentive Program;Requested clarification from CMS about providing care to justice-involved individuals and receiving Medicaid/Medicare reimbursement for such care to Made efforts in support of clarifying that hospitals may have designated units to care for patients in the custody of law enforcement/correctional institutions and may receive Medicaid reimbursement for care provided in such units; Support S. 872/ HR 1955Rural Hospital Access Act of 2017, a bill to amend title XVIII of the Social Security Act to make permanent the extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support S 1301/ HR 2267, Resident Physician Shortage Reduction Act of 2017, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1628 American Health Care Act / Better Care Reconciliation Act, a bill that would repeal and replace much of the Affordable Care Act, including repealing Medicaid expansion and the advanced premium tax credits for the purchase of coverage on the Health Insurance Marketplaces; Support S 1334/ HR 2797Patient Choices and Quality Care Act of 2017, a bill to provide for advanced illness care coordination services for Medicare beneficiaries; Urged the Administration to cancel Stage 3 of meaningful use by removing the 2018 start date from the regulation. The Administration also should institute a 90- day reporting period in every future year of the program, and gather input from stakeholders on ways to further reduce the burden of the meaningful use program from current requirements; Review S. 1169/ HR 2687, Medicaid Coverage for Addiction Recovery Expansion Act, a bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities; Review HR 2509 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Urged CMS to rescind the 25% Rule and instead rely on the site-neutral payment policy to bring transformative change to the LTCH field; Discussion with CMS about direct supervision of outpatient therapeutic services; Support HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; Discussed with Congress potential offsets to pay for CHIP and other Medicare extender legislation; Support straight extensions of the Medicare-dependent hospital and enhanced low-volume adjustment program; Support eliminating the reductions to Medicaid payments for DSH in fiscal years 2018 and 2019; Urged CMS to eliminate a duplicative budget-neutrality adjustment (BNA) being applied to Medicare payments for LTCH site-neutral cases, an unwarranted 5.1 percent cut. Urged CMS to permanently eliminate the LTCH 25% Rule policy; support The Limited Repeal of the IMD Exclusion for Adult Medicaid Beneficiaries with Substance Use Disorder Act, which would improve access to needed substance use disorder (SUD)treatment services for millions of Americans.

Client expense: $4,290,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), 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

PL 109442: Lifespan Respite Care Act; PL 109365: Older Americans Act Amendments of 2006; PL 111148: The Patient Protection and Affordable Care Act; PL 111152: Affordable Health Care for America Act; PHS 42 USC 254C8: Healthy Start Reauthorization of 2007; PL 111192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111-152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 1628: American Health Care Act of 2017; S 253/HR 807: Medicaid Access to Rehabilitation Services Act of 2017; FY 2017/2018 Labor, Health and Human Services, Education Appropriations; HR 3758/S 1028: Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act (PL 11-119); HR 2824: Increasing Opportunity and Success for Children and Parents through Evidence-Based Home Visiting Act; S 1827/HR 3921: Children's Health Insurance Program (CHIP); S 1829/HR 2824: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program; HR 3778: Direct CARE (Creation, Advancement, and Retention of Employment) Opportunity Act; and HR 5306/S 2227: Ensuring Medicaid Provides Opportunities for Widespread Equality, Resources (EMPOWER) Care Act.

Client expense: $47,764 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

HR 3298 Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) S.353 - Preserve Access to Medicare Rural Home Health Services Act of 2017 (all sections) R 3992 - Rural Home Health Extension and Regulatory Relief Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50208. Extension of home health rural add-on, Sec. 51001. Home health payment reform, Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services, Sec. 53110. Medicare payment update for home health services, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 244 - Consolidated Appropriations Act, 2017 (Division H - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017)

Client expense: $330,000 · 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

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act

Client expense: $292,000 · Firm income: Not reported

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

H.R. 807/S. 253 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) Medicare private contracting H.R. 4133 Medicare Patient Empowerment Act of 2017

Client expense: $292,000 · Firm income: Not reported

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

HR 807 and S 253 - legislation regarding rehab therapy spending caps in Medicare; HR 2556 and S 1016 - the CONNECT for Health Act; HR 2550 - the Medicare Telehealth Parity Act; S 787 - the Telehealth Innovation and Improvement Act; and S 431 - the Furthering Access to Stroke Telemedicine Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbying in support of the passage of HR807/S253 which seeks to repeal the cap on the amount of physical therapy which a Medicare beneficiary can receive; seeking reintroduction of bills to allow for physical therapists to use the locum tenens provisions of Medicare regardless of the location of their clinic, opt-out of Medicare. Lobbying in support of PPS-endorsed bills to allow for PTs to be reimbursed for care provided via telehealth as well as adding physical therapists to the National Health Service Corps. Advocated to protect the Essential Health Benefits in any regulations promulgated by CMS.

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

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

Lobbying in support of the passage of HR807/S253 which seeks to repeal the cap on the amount of physical therapy which a Medicare beneficiary can receive; evaluating quality and value-based payment models; and advocating for the use of outcome measures.

Client expense: Not reported · Firm income: Not reported

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

Medicare coverage and reimbursement for therapy services; Outpatient therapy caps (H.R. 807, S. 253);Medicare payment reform for post acute care services; and implementation of the Medicare Access and CHIP Reauthorization Act.

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

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

Support H.R. 1421/S. 568, providing for all time a Medicare beneficiary spends in the hospital to count toward the 3-day stay requirement for coverage of post-acute care. Support H.R. 807/S. 253 to repeal caps on Medicare coverage of outpatient therapy. Favored these provisions of Bipartisan Budget Act, H.R. 1892. Support S. 870, the CHRONIC Care Act, to improve Medicare coverage for beneficiaries with chronic health conditions. Supported these provisions of H.R. 1892. Advocating for modification of the nurse aide training lock-out provisions of the Omnibus Budget Reconciliation Act of 1987. Support S. 1334/HR 2797, the Patient Choice and Quality Care Act, to allow for better service coordination for Medicare beneficiaries with advanced illnesses. Support S. 445/H.R. 1825, the Home Health Planning Improvement Act, to allow non-physician health professionals to approve Medicare coverage of home health care. Support S. 309, Community-Based Independence for Seniors Act, establishing a demonstration of Medicare coverage of non-medical supportive services Support H.R. 2797/S. 1334, the Patient Choice and Quality Care Act, to create a new Medicare model for advanced illness care. Support H.R. 2663, Home Health Documentation and Program Improvement Act, to address the current backlog of appeals on claims for Medicare reimbursement. Support H.R. 3098, Medicare Adult Day Services Act Advocating for modification of the "settings rule" for Medicaid coverage of home care services provided to beneficiaries living on the campus of a nursing home or assisted living facility.

Client expense: $76,987 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2017 (S.568/H.R. 1421) Observation Stays Issue Outreach to HHS/CMS Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) Therapy caps exception process Group and Concurrent Therapy CR: Public Law No: 115-123 Omni: Public Law No: 115-141

Client expense: $990,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Preservation of Medicaid as an entitlement program and avoiding cuts, including per capita caps and block grants. Implementation of and improving the Achieving a Better Life Experience Act, P.L. 113-295, provisions added in P.L. 115-97. Implementation of the Affordable Care Act, P.L. 111-148 and P.L. 111-192 HCBS Settings Rule ABLE Age Adjustment Act, S. 817 and H.R. 1874 Permanently repealing Medicare Therapy Caps (H.R. 807, S. 253) Independence At Home 2 year extension (S. 464). Steve Gleason Act (S. 1132) to make permanent changes protecting access to speech generating devices.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA)

Support for S.253 / H.R. 807 - Medicare Access to Rehabilitation Services Act of 2017. Support for S. 977 / H.R. 3820 - Medicare Home Health Flexibility Act of 2017. Support for Section 50202 of H.R. 1892 - Bipartisan Budget Act of 2018.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-Bipartisan Health Care Stabilization Act, support bipartisan efforts led by Senators Alexander and Murray to stabilize and improve the individual health insurance market while protecting people with chronic conditions. -H.R. 807/S.253, Medicare Access to Rehabilitation Services Act, support passage. -H.R. 1892, Bipartisan Budget Act of 2018, support repeal of the Medicare therapy cap. -S. 1028/H.R. 3759, RAISE Family Caregivers Act, support passage. -H.R. 2439/S. 1131, FAIR Drug Pricing Act, support passage. - H.R. 2212/ S. 974, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 (CREATES Act), support passage. -H.R. 2077, Restoring Patients Voice Act, support passage. -S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act, support passage. - H.R. 2051, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 750, support passage of the Ensuring Access to Quality Complex Rehabilitation Technology Act. -H.R. 1361/S. 486/H.R. 3730, support passage to protect access to complex rehabilitative technology accessories. -H.R. 2535/S. 1188, Lifespan Respite Care Reauthorization Act, support reauthorization of the Lifespan Respite Care Program. -HR 2575/S. 1909, Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act

Client expense: $149,531 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE