A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool.

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Care Reform; Pathway to Covering America; Employer Based Healthcare System; Uninsured/Expanding Coverage; Healthcare Reform Modeling; Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts; Individual Manadate; HR 3200 "America's Affordable Health Choices Act of 2009"; S1679 "Affordable Health Choices Act"; Senate Finance Committee Chairman's Mark - no bill number "America's Healthy Future Act"; HR1321 and S391 "Healthy Americans Act" Government-run health insurance Plan; Government Plan Trigger; Co-Ops; Medicare Payment Rates; Provider Underpayments; Level Playing Field Affordable Private Health Care; proposed insurer fees; excise taxes on high value Plans; 5 to 1 Age Rating Bands; Realistic Minimum Benefit Values; Effective Individual Mandate; Sherlock Report; Healthcare Delivery System Reforms; Health Care Quality; Patient-centered Primary Care/Medical Home; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; evidence based care; Healthcare Delivery System Reforms; Pooling, Exchanges, Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs); Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification Antitrust and Health Insurance Reform; HR3596 "Health Insurance Industry Antitrust Enforcement Act of 2009" DELETING THE FOLLOWING HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; S.Res.156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool"; Blue Health Intelligence; and Share Decision Making.

Client expense: Not reported · Firm income: Not reported

Government targets: Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Care Reform; Pathway to Covering America; Employer Based Healthcare System; Uninsured/Expanding Coverage; Effective Individual Mandate; Health Coverage Responsibility; Affordable Private Health Care; Government Plan Option; FEHBP; Healthcare Reform Model; HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; American Health Choices Act Insurance Market Reform; Individual Market Reform; Small Group Market REform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts Patient-centered Primary Care/Medical Home; Health Care Quality; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Healthcare Delivery System Reforms Antitrust and Health Insurance Reform Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs) S.Res. 156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool" Health Information Technology Standards; Health Information Privacy; Electronic Health Records S386 "Fraud Enforcement and Recovery Act of 2009" sections pertaining to the False Claims Act

Client expense: Not reported · Firm income: Not reported

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Care Reform; Pathway to Covering America; Employer Based Healthcare System; Uninsured/Expanding Coverage; Effective Individual Mandate; Health Coverage Responsibility; Affordable Private Health Care; Government Plan Option; FEHBP; Healthcare Reform Model; HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; American Health Choices Act Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts Patient-centered Primary Care/Medical Home; Health Care Quality; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Healthcare Delivery System Reforms Antitrust and Health Insurance Reform Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs) S.Res.156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool" Health Information Technology Standards; Health Information Privacy; Electronic Health Records S386 "Fraud Enforcement and Recovery Act of 2009" sections pertaining to the False Claims Act

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

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Care Reform; Pathway to Covering America; Employer Based Healthcare System; Uninsured/Expanding Coverage; Effective Individual Mandate; Health Coverage Responsibility; Affordable Private Health Care; Government Plan Option; FEHBP; Healthcare Reform Model; HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; House - no bill number "America's Affordable Health Choices Act"; Senate HELP - no bill number "Affordable Health Choices Act"; Senate Finance proposal - no bill number Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts; Patient-centered Primary Care/Medical Home; Health Care Quality; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Healthcare Delivery System Reforms; Antitrust and Health Insurance Reform; Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs); S.Res.156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool"; Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; S386 "Fraud Enforcement and Recovery Act of 2009" sections pertaining to the False Claims Act; Prevention/Wellness incentives in FEHBP; Blue Health Intelligence; and Share Decision Making.

Client expense: $2,840,000 · Firm income: Not reported

See attached Addendum page Health Care Reform; Employer Based Healthcare System; Uninsured/Expanding Coverage; Effective Individual Mandate; Health Coverage Responsibility; Affordable Private Health Care; Government Plan Option; FEHBP; Healthcare Reform Model; HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; American Health Choices Act Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts Patient-centered Primary Care/Medical Home; Health Care Quality; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Healthcare Delivery System Reforms Antitrust and Health Insurance Reform Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs) S.Res.156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool" Health Information Technology Standards; Health Information Privacy; Electronic Health Records

Client expense: $34,500 · Firm income: Not reported

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Care Reform; Pathway to Covering America; Employer Based Healthcare System; Uninsured/Expanding Coverage; Effective Individual Mandate; Health Coverage Responsibility; Affordable Private Health Care; Government Plan Option; FEHBP; Healthcare Reform Model; dental and vision coverage HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; American Health Choices Act Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts Patient-centered Primary Care/Medical Home; Health Care Quality; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Healthcare Delivery System Reforms Antitrust and Health Insurance Reform Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs) S.Res.156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool" Health Information Technology Standards; Health Information Privacy; Electronic Health Records S386 "Fraud Enforcement and Recovery Act of 2009" sections pertaining to the False Claims Act

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

HR 1321 Healthy Americans Act S 525 Pharmaceutical Market Access and Drug Safety Act of 2009 HR1298 Pharmaceutical Market Access and Drug Safety Act of 2009 HR 1 The American Recovery and Reinvestment Act 2009 (PL 111-5) - health IT provisions HR 684 Medicare Prescription Drug Savings and Choice Act of 2009 S 330 Medicare Prescription Drug Savings and Choice Act of 2009 H CON RES 85 2010 Budget resolution - Medicare provisions S CON RES13 2010 Budget resolution - Medicare provisions S 391 Healthy Americans Act HR 2 Children's Health Insurance Program Reauthorization Act of 2009 S 275 Children's Health Insurance Program Reauthorization Act of 2009 S 584 Complete Streets Act of 2009 HR 1443 Complete Streets Act of 2009 S 634 Fitness Integrated with Teaching Kids Act HR 1585 Fitness Integrated with Teaching Kids Act S 803 Healthy Workforce Act of 2009 HR 1897 Healthy Workforce Act of 2009 S 726 Promoting Innovation and Access to Life-Saving Medicine Act HR 1427 Promoting Innovation and Access to Life-Saving Medicine Act S 979 Small Business Health Options Program Act of 2009 HR 2360 Small Business Health Options Program Act of 2009 S Res 156 A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool. HR 2520 Patients' Choice Act S 1099 Patients' Choice Act

Client expense: $580,000 · Firm income: Not reported

HR 2 To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes HR 716 To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group and individual health insurance coverage and group health plans to provide coverage for individuals participating in approved cancer clinical trials HR 859 To encourage the development of small business cooperatives for healthcare options to improve coverage for employees (CHOICE) including through a small business CHOICE tax credit HR 956 To expand the number of individuals and families with health insurance coverage, and for other purposes HR 1253 The Health Insurance Restrictions and Limitations Clarification Act of 2009, would require that group health plan sponsors disclosure coverage limits and restrictions in a timely, easily understandable fashion. HR 1558 To amend title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to prohibit preexisting condition exclusions in group health plans and health insurance coverage in the group and individual markets H.R. 2427 to amend title XXVII of the Public Health Service Act to establish federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a federal office of health insurance oversight to monitor performance in those markets, and for other purposes H.R. 2520 to provide comprehensive solutions for the health care system of the United States, and for other purposes S 179 To improve quality in health care by providing incentives for adoption of modern information technology S 623 To amend title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Service Act, and the Internal Revenue Code of 1986 to prohibit preexisting condition exclusions in group health plans and in health insurance coverage in the group and individual markets S 803 A bill to amend the Internal Revenue Code of 1986 to provide a tax credit to employers for the costs of implementing wellness programs, and for other purposes. S. Amdt 98 In the nature of a substitute S. 988 to amend the Internal Revenue Code of 1986 to allow small businesses to set up simple cafeteria plans to provide nontaxable employee benefits to their employees, to make changes in the requirements for cafeteria plans, flexible spending accounts, and benefits provided under such plans or accounts, and for other purposes S. 979 to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible S. 1050 to amend title XXVII of the Public Health Service Act to establish federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a federal office of health insurance oversight to monitor performance in those markets, and for other purposes S. 1099 to provide comprehensive solutions for the health care system of the United States, and for other purposes S. 1149 to eliminate annual and lifetime aggregate limits imposed by health plans S. 1152 to allow Americans to earn paid sick time so that they can address their own health needs and the health needs of their families S. Res. 156 expressing the sense of the Senate that reform of our nation's health care system should include the establishment of a federally-backed insurance pool

All aspects of healthcare reform - S 1054, An original bill making supplemental appropriations for the fiscal year ending September 30, 2009, and for other purposes; SRes 156, A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool; proposed legislation re this issue. Including healthcare reform in Reconciliation - HConRes 85, Setting forth the congressional budget for the United States Government for fiscal year 2010 and including the appropriate budgetary levels for fiscal years 2009 and 2011 through 2014; SConRes 13, An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2010, revising the appropriate budgetary levels for fiscal year 2009, and setting forth the appropriate budgetary levels for fiscal years 2011 through 2014. Universal healthcare reform - potential legislation. Healthcare alternatives to Administration's budget proposals - HConRes 85, Setting forth the congressional budget for the United States Government for fiscal year 2010 and including the appropriate budgetary levels for fiscal years 2009 and 2011 through 2014; SConRes 13, An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2010, revising the appropriate budgetary levels for fiscal year 2009, and setting forth the appropriate budgetary levels for fiscal years 2011 through 2014; potential legislation. Health-related provisions - HConRes 85, Setting forth the congressional budget for the United States Government for fiscal year 2010 and including the appropriate budgetary levels for fiscal years 2009 and 2011 through 2014; SConRes 13, An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2010, revising the appropriate budgetary levels for fiscal year 2009, and setting forth the appropriate budgetary levels for fiscal years 2011 through 2014. Single-payer health reform - HR 15, To provide a program of national health insurance, and for other purposes; HR 676, To provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 1200, To provide for health care for every American and to control the cost and enhance the quality of the health care system; S 703, A bill to provide for health care for every American and to control the cost and enhance the quality of the health care system. Essential benefits plan, high-risk pools - HR 109, To provide for the offering of Health Benefit Plans to individuals, to increase funding for State high risk health insurance pools, and to promote best practice protocols for State high risk pools. New government health program - HR 193, To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. FSA rollovers - HR 544, To amend the Internal Revenue Code of 1986 to allow amounts in a health flexible spending arrangement that are unused during a plan year to be carried over to subsequent plan years or deposited into certain health or retirement plans. Health IT and privacy issues - HR 598, To provide for a portion of the economic recovery package relating to revenue measures, unemployment and health; HR 629, To provide energy and commerce provisions of the American Recovery and Reinvestment Act of 2009; HR 1, Making supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009, and for other purposes. Data security - HR 2221, To protect consumers by requiring reasonable security policies and procedures to protect computerized data containing personal information, and to provide for nationwide notice in the event of a security breach. Price transparency - HR 2249, To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. Association health plans - HR 2607, To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Medical liability reform - HR 1086, To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1468, To provide health care liability reform, and for other purposes; S 45, A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. Antitrust exemption for physicians - HR 1493, To ensure and foster continued patient safety and quality of care by exempting health care professionals from the Federal antitrust laws in their negotiations with health plans and health insurance issuers. Third-party billing by VA for service-connected disabilities - HR 1658, To amend title 38, United States Code, to prohibit the recovery by the United States of charges from a third party for hospital care or medical services furnished to a veteran for a service-connected disability. Health information technology - S 179, A bill to improve quality in health care by providing incentives for adoption of modern information technology. Pilot projects for State-based health reforms - S 698, A bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system. Comparative effectiveness research - HR 2502, To amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Comparative Effectiveness Research Trust Fund, and for other purposes; HR 3002, To protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1213, A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes; S 1259, A bill to protect all patients by prohibiting the use of data obtained from comparative effectiveness research to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response. Government-run health plan - HR 2668, To provide for the offering of an American Trust Health Plan to provide choice in health insurance options so as to ensure quality, affordable health coverage for all Americans; S 1278, A bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers. Fraud and abuse - S 458, A bill to amend the False Claims Act. Wellness incentives - S 913, A bill to amend the Internal Revenue Code of 1986 to expand workplace health incentives by equalizing the tax consequences of employee athletic facility use. Cafeteria plans, flexible spending arrangements - S 988, A bill to amend the Internal Revenue Code of 1986 to allow small businesses to set up simple cafeteria plans to provide nontaxable employee benefits to their employees, to make changes in the requirements for cafeteria plans, flexible spending accounts, and benefits provided under such plans or accounts, and for other purposes. Comprehensive health reform - S 1099, A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes.

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Care Reform; Pathway to Covering America; Employer Based Healthcare System; Uninsured/Expanding Coverage; Effective Individual Mandate; Health Coverage Responsibility; Affordable Private Health Care; Government Plan Option; FEHBP; Healthcare Reform Model; HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; American Health Choices Act Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts Patient-centered Primary Care/Medical Home; Health Care Quality; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Healthcare Delivery System Reforms Antitrust and Health Insurance Reform Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs) S.Res.156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool" Health Information Technology Standards; Health Information Privacy; Electronic Health Records S386 "Fraud Enforcement and Recovery Act of 2009" sections pertaining to the False Claims Act

Client expense: Not reported · Firm income: Not reported

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Health Care Reform; Pathway to Covering America; Employer Based Healthcare System; Uninsured/Expanding Coverage; Effective Individual Mandate; Health Coverage Responsibility; Affordable Private Health Care; Government Plan Option; FEHBP; Healthcare Reform Model; HR1321 and S391 "Healthy Americans Act"; HR1897 and S803 "Healthy Workforce Act of 2009"; American Health Choices Act Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts Patient-centered Primary Care/Medical Home; Health Care Quality; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Healthcare Delivery System Reforms Antitrust and Health Insurance Reform Federal Connectors; Virtual Connectors; State Insurance Marts (SIMs) S.Res.156 "A resolution expressing the sense of the Senate that reform of our Nation's health care system should include the establishment of a federally-backed insurance pool" Health Information Technology Standards; Health Information Privacy; Electronic Health Records S386 "Fraud Enforcement and Recovery Act of 2009" sections pertaining to the False Claims Act

Client expense: $349,929 · Firm income: Not reported