NANCY FOSTER

DRAFTBill, the Safety from Violence for Healthcare Employees (SAVE) Act, all provisions; H.R.929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; DRAFT Bill, Mental Health Infrastructure Improvement Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; DRAFT Bill, Healthcare Workforce Resilience Act, all provisions; DRAFT Bill, 340B PATIENTS Act , all provisions; H.R. 1417, The Rural Health Care Technical Assistance Program Act, all provisions; S. 229, Drug-price Transparency for Consumers (DTC) Act, all provisions; H.R.330, Organ Donation Referral Improvement Act, Issues pertaining to organ donation referral process; S. 526, Pharmacy Benefit Manager Reform Act, Pharmacy benefit management services; Drug Enforcement Administration, DEAs proposed rule; Physician-Focused Payment Model Technical Advisory Committee, Population-based total cost-of-care; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Price Transparency, Issues related to hospital price transparency; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP); Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Nurse staffing mandate, workforce development programs; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, cyberattacks, and securing supply chains; Post-Acute Care, Issues pertaining to how Congress can better support patients' access to crucial services provided by Long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay; Hospital mergers and acquisitions, Issues pertaining to hospital consolidation, mergers an acquisition, physician practice acquisition, FTC premerger notification rules; Rural Emergency Hospital Designation, Issues pertaining to eligibility for the Rural Emergency Hospital designation and the expansion of physician-owned hospitals.

H.Con.Res.14, Establishing the congressional budget for the United States Government for fiscal year 2025 and setting forth the appropriate budgetary levels for fiscal years 2026 through 2034, Title II - Reconciliation and Related Matters; H.R. 1968, The Full-Year Continuing Appropriations and Extensions Act, 2025, Division B / Title I - Public Health Extenders, Disaster Relief Funds, Ensuring hospitals are compensated for pandemic expenses.

White House, Tariffs on Canada, Mexico, and China, Tariff impact on supply chain for drugs and devices, Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax-exempt status and tax-exempt private activity bonds, Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits.

Support a bill to reauthorize the program of payments to childrens hospitals that operate graduate medical education programs; advocate appropriations priorities regarding funding for health care programs for fiscal year (FY) 2024, Continue to monitor the FY 2024 budget to prevent or minimize hospital cuts.

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110, Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, supporting policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961, Pharmaceutical Supply Chain Risk Assessment Act of 2023, A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; support the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act, It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule; A letter to comment on ways to improve access to care in rural and underserved areas ensuring that Americans in these rural and underserved areas have high-quality, affordable health care; Support S. 2016/ H.R. 4189, CONNECT for Health Act of 2023, a bill to support to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; A letter to the Department of Veterans Affairs (VA) expressing significant concerns about Cotivitis audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed; Support S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, a bill to support Healthcare Workforce Resilience Act to enhance our Nations nurse and physician workforce by recapturing unused immigrant visas; Support for Reauthorization of PAPHA, The Pandemic and All-Hazards Preparedness Act (PAHPA), To amend the Public Health Service Act to reauthorize certain programs with respect to public health security and all-hazards preparedness and response related to the Administration for Strategic Preparedness and Response and certain programs with respect to public health security and all-hazards preparedness and response related to the Centers for Disease Control and Prevention, and for other purposes; Support H.R. 6430, Rural Community Hospitals (ARCH) Act, a bill to support the Assistance for Rural Community Hospitals (ARCH) Act; To support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges, Congress established the Medicare- dependent Hospital (MDH) program in 1987, allowing eligible hospitals to receive the sum of their prospective payment system (PPS) payment rate, plus three- quarters of the amount by which their cost per discharge exceeds the PPS rate; Support H.R. 4531/ S.3393, Patients and Communities Reauthorization Act, a bill to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; A letter to the FDA on its laboratory developed tests (LDTs) proposed rule urging the agency to not apply its device regulations to hospital and health system LDTs because they are not devices; rather, they are diagnostic tools developed and used in the context of patient care. Instead, we urged the FDA to continue to apply its enforcement discretion to hospital and health system LDTs; Submit Statement to the Committee on Energy and Commerce Subcommittee on Health hearing, Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care to share the hospital fields comments on proposed regulations for minimum staffing standards for LTC facilities and their potential impact on access to care; Concern H.R. 5378 Lower Costs, More Transparency Act, A bill to promotes price transparency in the health care sector, and for other purposes; Hill Briefing on SAVE Act, Support S. 2768 / H.R. 2584, The Safety from Violence for Healthcare Employees (SAVE) Act, A bill to protect hospital personnel from violence, and for other purposes; Health Care Spending in the United States: Unsustainable for Patients, Employers, and Taxpayers; Statement to the House Committee on Energy and Commerce Subcommittee on Health regarding the topic of national health expenditures, The Independent Dispute Resolution Process (IDR), To comment on the proposed rule related to the operations of the Independent Dispute Resolution Process (IDR) established by the No Surprises Act (NSA); Examining Chronic Drug Shortages in the United States, Statement to the House Committee on Ways and Means regarding the important topic of drug shortages in the United States; Support H.R. 6205 / S. 3211, Healthcare Workforce Resilience Act, A bill to reauthorize title II of the Higher Education Act of 1965, and for other purposes; H.R. 7513; Protecting Americas Seniors Access to Care, Statement to the House Committee on Ways and Means regarding Protecting Americas Seniors Access to Care to prohibit the Secretary of Health and Human Services from finalizing a proposed rule regarding minimum staffing for nursing facilities, and to establish an advisory panel on the skilled nursing facility workforce; Enhancing Access to Care at Home in Rural and Underserved Communities, Statement to the House Committee on Ways and Means on how telehealth flexibilities, the hospital-at-home (H@H) program and home health agencies have expanded access to care for patients in their homes and the need for these programs to continue; The recent cyberattack on Change Healthcare, Letter to House and Senate leadership requesting assistance for hospitals impacted by the cyberattack; The recent cyberattack on Change Healthcare, Letter to Senate Finance Committee leadership to share concerns regarding the Administrations proposal to penalize hospitals that do not meet certain cybersecurity requirements; Support S. 3779 / H.R. 7265, Child Suicide Prevention and Lethal Means Safety Act, A bill authorizing the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDAs Proposed Rule.", Statement to the House Committee on Energy and Commerce Subcommittee on Health on the impact of the Food and Drug Administrations (FDA) proposed regulation of diagnostic tests; Senate RFI on the SUSTAIN 340B Act Draft, A letter to provide feedback on the Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of (SUSTAIN) 340B Act bipartisan discussion draft and accompanying request for information on the 340B Drug Pricing Program; Access to Health Care in America: Ensuring Resilient Emergency Medical Care, Statement to the House Committee on Ways and Means on access to emergency medical services in rural areas; Support H.R. 7623, Telehealth Modernization Act, A bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program; House RFI on strengthening ERISA, A letter to provide feedback on an RFI from the House Education and Workforce Committee on ways to strengthen and improve ERISA, Addressing drug shortagesAHAs statement for record to Ways and Means committee hearing on Examining Chronic Drug Shortages in the United States, Statement commenting on the impact of the FDAs proposed regulation of laboratory developed tests (LDTs), AHAs statement for the record to Energy and Commerce Subcommittee on Health on "Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDAs Proposed Rule.", Response to RFI on oversight and regulation of LDTs, Response to Sen. Cassidy, Ranking Member of HELP Committee on his RFI seeking feedback on the FDAs proposed regulation of hospital LDTs, OMB meeting, including FDA officials, on the FDAs rulemaking on the regulation of hospital LDTs as medical devicesOMB/FDA; Support S 3679 / H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, A bill to reauthorize the Dr. Lorna Breen Health Care Provider Protection Act, and for other purposes, Support S. 1110, the Rural Hospital Support Act, A bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support HR 1565, Critical Access Hospital Relief Act of 2023, A bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services.

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Hill outreach about the anticompetitive behaviors of travel nurse staffing agencies; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an Request For Information on the reauthorization of the Pandemic and All-Hazards Preparedness Act; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Support HR 2584/S.2768, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purpose; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, we encourage you to consider policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Hill briefing, Site-neutral Payment Proposals Would Jeopardize Access to Care for Patients and Communities; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961Pharmaceutical Supply Chain Risk Assessment Act of 2023A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; Drug Shortage Prevention Act Letter to express support for the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Bipartisan request for information on the critically important 340B Drug Pricing Program Letter on the savings 340B hospitals achieve through purchasing certain outpatient drugs at a discount allow them to provide a range of programs and services that directly benefit their patients; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Energy and Commerce and Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule; A letter to comment on ways to improve access to care in rural and underserved areas ensuring that Americans in these rural and underserved areas have high-quality, affordable health care; Support S. 2016/ H.R. 4189, CONNECT for Health Act of 2023, a bill to support to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; A letter to the Department of Veterans Affairs (VA) expressing significant concerns about Cotivitis audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed; Support S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, a bill to support Healthcare Workforce Resilience Act to enhance our Nations nurse and physician workforce by recapturing unused immigrant visas; Support for Reauthorization of PAPHA, The Pandemic and All-Hazards Preparedness Act (PAHPA), To amend the Public Health Service Act to reauthorize certain programs with respect to public health security and all-hazards preparedness and response related to the Administration for Strategic Preparedness and Response and certain programs with respect to public health security and all-hazards preparedness and response related to the Centers for Disease Control and Prevention, and for other purposes; Support H.R. 6430, Rural Community Hospitals (ARCH) Act, a bill to support the Assistance for Rural Community Hospitals (ARCH) Act; To support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges, Congress established the Medicare- dependent Hospital (MDH) program in 1987, allowing eligible hospitals to receive the sum of their prospective payment system (PPS) payment rate, plus three- quarters of the amount by which their cost per discharge exceeds the PPS rate; Support H.R. 4531/ S.3393, Patients and Communities Reauthorization Act, a bill to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; A letter to the FDA on its laboratory developed tests (LDTs) proposed rule urging the agency to not apply its device regulations to hospital and health system LDTs because they are not devices; rather, they are diagnostic tools developed and used in the context of patient care. Instead, we urged the FDA to continue to apply its enforcement discretion to hospital and health system LDTs; Submit Statement to the Committee on Energy and Commerce Subcommittee on Health hearing, Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care to share the hospital fields comments on proposed regulations for minimum staffing standards for LTC facilities and their potential impact on access to care.

Hill outreach to oppose site-neutral payment cuts; Hill outreach in support of the Acute Hospital Care at Home program; Hill outreach about streamlining prior authorization in Medicare Advantage plans; AHA Letter Comments on Medicare Payment Advisory Commission 2024 Payment Proposals; Support S. 803, Save Rural Hospitals Act of 2023, a bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; Letter comments on three topics that were discussed during the March 2023 Medicare Payment Advisory Commission (MedPAC) public meeting: the hospital wage index, alignment of payment rates across ambulatory settings and Medicare Part B drug payments. Agrees that the current wage index system is flawed, but continues to have concerns about the use of non-hospital data in an alternative wage index system; recommends that the commission reject modifications to the current average sales price (ASP)-plus-6% methodology; and urges the commission not to recommend additional site-neutral payment cuts; Support HR 2665, Supporting Safety Net Hospitals Act, a bill to amend title XIX of the Social Security Act to delay certain disproportionate share hospital payment reductions under the Medicaid program; Comment letter to CMS opposes the proposal to limit the inclusion of patient days for patients who are regarded as eligible for Medicaid benefits under a Section 1115 demonstration project for purposes of the Medicare DSH calculation; Comment letter to CMS regarding a proposed rule to improve access, quality and health outcomes for Medicaid programs and the proposed policies related to access, finance and quality in Medicaid and CHIP managed care programs; Support H.R. 4968 GOLD Card Act of 2023A bill to amend title XVIII of the Social Security Act to exempt qualifying physicians from prior authorization requirements under Medicare Advantage plans, and for other purposes; Support H.R.5378 Lower Costs, More Transparency Act A bill to promote price transparency in the health care sector, and for other purposes; A comment letter on the Centers for Medicare & Medicaid Services (CMS) hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system proposed rule for calendar year (CY) 2024. The letter urges CMS to examine ways to account for these increased costs to ensure that beneficiaries continue to have access to quality outpatient care. It also urges the agency to reduce the productivity cut for CY 2024 as such a cut does not align with hospital and health systems public health emergency (PHE) experiences related to actual losses in productivity during the COVID-19 pandemic; Hill outreach to oppose the elimination of facility fees; Hill outreach to oppose changes that would prevent providers from negotiating contracting restrictions with commercial health insurance plans.

Continue to monitor the FY 2023 budget to prevent or minimize hospital cuts; Support a bill to reauthorize the program of payments to childrens hospitals that operate graduate medical education programs; Letter to House and Senate Labor/ HHS Appropriations Subcommittee Chairs and Ranking Members on appropriations priorities regarding funding for health care programs for fiscal year (FY) 2024. Americas hospitals are facing many challenges and we appreciate you considering the effect your decisions have on hospitals ability to provide care to their patients and communities. We ask you to give favorable consideration to funding for health care programs that have proven successful in improving access to quality health care for patients and communities across America.

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Hill outreach about the anticompetitive behaviors of travel nurse staffing agencies; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an Request For Information on the reauthorization of the Pandemic and All-Hazards Preparedness Act; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Support HR 2584, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purpose; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, we encourage you to consider policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Hill briefing, Site-neutral Payment Proposals Would Jeopardize Access to Care for Patients and Communities.

Continue to monitor the FY 2023 budget to prevent or minimize hospital cuts; Support a bill to reauthorize the program of payments to childrens hospitals that operate graduate medical education programs; Letter to House and Senate Labor/ HHS Appropriations Subcommittee Chairs and Ranking Members on appropriations priorities regarding funding for health care programs for fiscal year (FY) 2024. Americas hospitals are facing many challenges and we appreciate you considering the effect your decisions have on hospitals ability to provide care to their patients and communities. We ask you to give favorable consideration to funding for health care programs that have proven successful in improving access to quality health care for patients and communities across America.

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; Provide comment letter to OSHA on the re-opening of comments on the Occupational Exposure to COVID-19 Rulemaking in which we urge OSHA not to finalize its rule for occupational exposure to COVID-19. In our comments, we indicate that we continue to oppose establishing new regulations that are not fully aligned with the Centers for Disease Control and Preventions evolving evidence-based guidance. With the constantly evolving, science-based CDC guidance and recommendations, CMS vaccination requirement and existing OSHA general standards, we strongly believe that an inconsistent and overly strict OSHA COVID-19 health care standard is not necessary, would cause confusion and will ultimately lower hospital employees morale and worsen unprecedented personnel shortages in hospitals. It is essential to a well-functioning health care system that only one set of science-based standards be applied to health care providers, and that these standards be aligned across federal agencies; Letter urging Congress to make the expanded tax credits permanent, ensuring millions of low- and middle-income families continue to have access to affordable coverage in 2023 and beyond; Express concerns with the letter to CMS from Congressman Murphy that makes a number of requests for data surrounding the COVID-19 add on payments for hospitals. We are concerned about the questions as they do not take into account the continued needs of the nations hospitals and health systems. Hospitals continue to face numerous challenges, including increased labor and supply costs and workforce shortages. These additional payments have helped to address some but not all of the high costs associated with COVID-19 patient care. The complexity of care is still higher than pre-pandemic levels as measured by length of stay, which further indicates that its still more resource intensive to treat COVID inpatients. In addition, the high costs associated personal protective equipment, isolation measures, and other additional resources are necessary when treating all patients, unless and until it is determined they do not have COVID-19; Submitted a letter to Ways and Means per their request for information on the health care industry and climate change. We support the sustainability efforts while acknowledging that for a variety of reasons, many hospitals and health systems face challenges and barriers to implementing this work, especially while responding to a pandemic; Letter urging HHS to maintain the COVID-19 public health emergency (PHE) until it is clear that the global pandemic has receded and the capabilities authorized by the PHE are no longer necessary. This will help prevent any future surges from threatening the health and safety of patients and the ability of health care professionals to care for them; Long COVID Best Clinical Practices Discussion with the White House Policy Advisor, Office of the COVID-19 Response; Submitted comment letter to the Federal Trade Commission outlining the impact pharmacy benefit managers (PBMs) practices have on the field. Specifically, urging the FTC to increase scrutiny on insured-mandated white bagging policies, as well as the impact of PBM-negotiated rebates and other business practices on the 340B drug discount pricing program and overall drug prices and drug price increases; Submit a comment letter to the Internal Revenue Service for their proposed rule amending how employer coverage affordability would be measured for family members of employees. We advocated for a fix to the current methodology for assessing affordability of employer coverage for family members, often referred to as the family glitch, which is estimated to affect about 5 million individuals. We commend the IRS on proposing to revise the regulation and improve access to health insurance coverage for millions of American families; Concerns S.4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 or the FDASLA Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological product; Comment letter on CMS Radiation Oncology (RO) Model proposed rule. We strongly supports CMS efforts to transform the delivery of cancer care. We also support the original intent of the RO Model, which was to protect access to care by ensuring fair, predictable payment for radiation oncologists. However, this important goal of the original RO Model has been marred by the incorporation of significant payment cuts and substantial administrative burdens for those participating in this mandatory model. As such, the AHA supports CMSs proposal to delay the start date of the RO model from Jan. 1, 2023 to a date to be determined through future rulemaking; Support S. 4352,Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Letter in response to CMS request for guidance on implementing the regulatory requirement for convening providers and facilities exchange information with co-providers and co-facilities to create a comprehensive good faith estimate as part of the implementation of the No Surprises Act. Due to the lack of currently available automated solutions, this process would require a significant manual effort by providers, which would undoubtedly result in the convening provider being unable to meet the short statutory timeframes for delivering good faith estimates to the patients and could also lead to inadvertent errors. AHA has requested an extension in enforcement direction until a technical solution has been identified and implemented; Support HR 7691, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purposes; Letter requesting that HHS, HRSA, and OIG take immediate enforcement action against the now 17 companies that are refusing to honor their obligations under the 340B program; Letter sent to HHS Secretary to discuss how best to ensure prompt repayment to 340B hospitals without penalizing the rest of the hospital field after the U.S. Supreme Court unanimously agreed that HHS outpatient payment cuts to hospitals in the 340B Drug Pricing Program were unlawful. The Courts decision did not determine a remedy for the unlawful payment cuts, instead, it remanded the case to the lower courts to address the proper remedy; Support HR 7084/ S 3983, Protecting and Transforming Cyber Health Care Act of 2022 or the PATCH Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to require, for purposes of ensuring cybersecurity, the inclusion in any premarket submission for a cyber device of information to demonstrate a reasonable assurance of safety and effectiveness throughout the lifecycle of the cyber device, and for other purposes; Submit Comment letter of support for CMS continued focus on strengthening health insurance coverage and ensuring ease of enrollment and limited gaps in coverage, including proposed updates to Medicare enrollment and eligibility rules; Submit letter for oversight hearing on Medicare Advantage (MA) plans expressing concerns about some MA plans inappropriate restrictions on beneficiary access to medically necessary care, including those highlighted in a recent report issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG), and urge Congress to increase its oversight of these plans; Provided feedback on the Senate Finance Committees discussion draft addressing mental health care and telehealth. AHA supports allowing Medicare beneficiaries who seek treatment for mental health disorders to receive their care through audio-only services, removing the requirement for Medicare patients to receive an in-person visit prior to receiving mental health services through telehealth, and expanding beyond physicians and limited non-physician practitioners the types of providers who can deliver and bill for telehealth services; Support HR 8576/ S 4352 Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Support HR 8806 Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Submitted a statement for the record for the Senate Judiciary Subcommittee hearing on Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce. This hearing examines the importance of improving the immigration process in order to help alleviate Americas health care workforce shortage. We encourage Congress to help address domestic health care workforce shortage;

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887/ S. 4009, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program; Support H.R. 5425/ S. 1988, Protecting Rural Telehealth Access Act, a bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program; Letter asking Congress to address two important issues by the end of the year: an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect; Letter urging Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act; Support H.R. 5674/ S. 3061Medicare Mental Health Inpatient Equity Act of 2021, 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; Letter to the HHS secretary asking for PHE extension and urging HHS to extend the declaration for at least 90 days; Letter to the HHS secretary asking to renew the COVID-19 PHE; Letter to CMS urging changes to MA prior authorization requirements for PHE; Letter expressing our disappointment that Congress is adjourning for April recess without addressing the needs of hospitals and health systems and urging Congress to act to ensure health care providers have the critical relief, including but not limited to extending the Medicare sequester relief, adding more PRF dollars, and providing flexibility in the repayment terms for Medicare accelerated and advance repayments; Provide comments in response to the (CMS) request for information regarding access to coverage and care in the Medicaid and Childrens Health Insurance Program (CHIP) programs. The critical components for a comprehensive access and coverage strategy for Medicaid and CHIP should include: Robust outreach and enrollment efforts to secure and maintain coverage for eligible individuals and families, as well as ensure beneficiary knowledge of how to use this coverage, Standards to ensure timely and equitable access to quality care, and Provider payments that are sufficient to enable beneficiaries' access to quality care; Provide comments in response to the Department of Homeland Securitys (DHS) proposed rule to codify standards and clarify policies that govern public charge determinations. Public charge determinations assess how likely it is that an individual will become dependent on government assistance (public benefits) for support and subsistence. These policy clarifications are intended to help immigrants and their family members better understand when the use of certain public benefits could impact their future immigration status and address the chilling effects of the now-repealed 2019 public charge final rule. The AHA supports DHSs efforts to clarify policies regarding how public charge determinations are made to help reverse the damaging effects of the repealed 2019 public charge rule; A bill to amend title XIX of the Social Security Act to expand the availability of mental, emotional, and behavioral health services under the Medicaid program; Letter urging Congress to halt further cuts to hospital payments. Need to stop a harmful Medicare payment cut to providers that will go into effect July 1 without congressional action. Specifically, a 1% Medicare sequester cut took effect April 1, and that cut will increase to 2% on July 1 if Congress does not act. This will result in billions of dollars being cut from hospitals and health systems by the end of the year; Submitted comment letter regarding Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2023 and Updates to the IRF Quality Reporting Program. We note that the proposed IRF PPS labor-related share would only modestly shift upward from 72.9% in FY 2022 to 73.2% in FY 2022. AHA is concerned that these changes neither align regarding massive cost growth in recent months and years; Provide Comments on the Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities and Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023 which stated the Proposed FY 2023 Payment Update warrants closer examination and we urge CMS to discuss in the final rule how the agency will account for these increased costs. The timing of this proposed net decrease in payments could not be worse, given the well-documented impact of the COVID-19 public emergency (PHE) on the SNF and nursing home field; Letter sent to the bipartisan, bicameral Leadership of the House and Senate, urging Congress to act to prevent further Medicare sequester cuts scheduled to take effect on July 1; Submitted comment letter about inpatient and long-term care hospital prospective payment system proposed rule for fiscal year 2023. Concerned that CMS is proposing policies and payment adjustment that do not take into account the current the COVID-19 public health emergency (PHE) and its atypical market forces and pandemic-driven aberrations affecting the utilization and cost of providing LTCH services. Specifically, we are concerned by proposals for an inadequate market basket update and an untenable spike in the high-cost outlier threshold; Letter urges Congress to call on CMS to make changes to the hospital inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2023 in order to ensure that Medicare payments for acute care services more accurately reflect the cost of providing hospital care to patients and communities; Support the bipartisan Dear Colleague letters that ask CMS to make critical changes to the hospital inpatient prospective payment system proposed rule for fiscal year (FY) 2023 to more accurately reflect the cost of providing hospital care to patients; Support HR 8487/ S 3173 Improving Seniors Timely Access to Care Act of 2022, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans; Support HR 8747 Assistance for Rural Community Hospitals Act of 2022 or the ARCH Act of 2022, a bill to amend title XVIII of the Social Security Act to extend Medicare-dependent hospital and Medicare low-volume hospital payments; Oppose HR 1330/ S 4130 Patient Access to Higher Quality Health Care Act of 2022, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 8188/ S4449 Saving Access to Laboratory Services Act, a bill to amend title XVIII of the Social Security Act to improve the accuracy of market-based Medicare payment for clinical diagnostic laboratory services, to reduce administrative burdens in the collection of data, and for other purposes; Letter urged Congress to prevent the Statutory Pay-As-You-Go Act of 2010 (Statutory PAYGO) sequester from taking effect at the end of this session of Congress. Failure to waive Statutory PAYGO sequester cuts would result in $38 billion in Medicare cuts in fiscal year 2023 which would have a devastating impact on the health care field, destabilizing health care access; Letter expressing opportunities to increase participation, enhance efficacy of Medicare Access and CHIP Reauthorization Act (MACRA) programs, and further transition our health care system from volume to value; Letter to provide feedback on the cybersecurity policy proposals released in Senator Warner report. Hospitals and health systems have prioritized protecting patients and defending their networks from cyberattacks. However, they need support from the federal government as the field continues to face targets from sophisticated cyber adversaries and nation-states; Letter to leadership encouraging Congress to take steps to provide relief to those seeking and administering behavioral health care; Support HR 7744, Building Americas Health Care Workforce Act, a bill to amend title XI of the Social Security Act to extend beyond the COVID-19 emergency period, with certain modifications, the Emergency Declaration Blanket Waiver relating to training and certification of nurse aides to alleviate burdens imposed on staff of skilled nursing facilities and nursing facilities.

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887/ S. 4009, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program; Support H.R. 5425/ S. 1988, Protecting Rural Telehealth Access Act, a bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program; Letter asking Congress to address two important issues by the end of the year: an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect; Letter urging Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act; Support H.R. 5674/ S. 3061Medicare Mental Health Inpatient Equity Act of 2021, 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; Letter to the HHS secretary asking for PHE extension and urging HHS to extend the declaration for at least 90 days; Letter to the HHS secretary asking to renew the COVID-19 PHE; Letter to CMS urging changes to MA prior authorization requirements for PHE; Letter expressing our disappointment that Congress is adjourning for April recess without addressing the needs of hospitals and health systems and urging Congress to act to ensure health care providers have the critical relief, including but not limited to extending the Medicare sequester relief, adding more PRF dollars, and providing flexibility in the repayment terms for Medicare accelerated and advance repayments; Provide comments in response to the (CMS) request for information regarding access to coverage and care in the Medicaid and Childrens Health Insurance Program (CHIP) programs. The critical components for a comprehensive access and coverage strategy for Medicaid and CHIP should include: Robust outreach and enrollment efforts to secure and maintain coverage for eligible individuals and families, as well as ensure beneficiary knowledge of how to use this coverage, Standards to ensure timely and equitable access to quality care, and Provider payments that are sufficient to enable beneficiaries' access to quality care; Provide comments in response to the Department of Homeland Securitys (DHS) proposed rule to codify standards and clarify policies that govern public charge determinations. Public charge determinations assess how likely it is that an individual will become dependent on government assistance (public benefits) for support and subsistence. These policy clarifications are intended to help immigrants and their family members better understand when the use of certain public benefits could impact their future immigration status and address the chilling effects of the now-repealed 2019 public charge final rule. The AHA supports DHSs efforts to clarify policies regarding how public charge determinations are made to help reverse the damaging effects of the repealed 2019 public charge rule; A bill to amend title XIX of the Social Security Act to expand the availability of mental, emotional, and behavioral health services under the Medicaid program; Letter urging Congress to halt further cuts to hospital payments. Need to stop a harmful Medicare payment cut to providers that will go into effect July 1 without congressional action. Specifically, a 1% Medicare sequester cut took effect April 1, and that cut will increase to 2% on July 1 if Congress does not act. This will result in billions of dollars being cut from hospitals and health systems by the end of the year; Submitted comment letter regarding Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2023 and Updates to the IRF Quality Reporting Program. We note that the proposed IRF PPS labor-related share would only modestly shift upward from 72.9% in FY 2022 to 73.2% in FY 2022. AHA is concerned that these changes neither align regarding massive cost growth in recent months and years; Provide Comments on the Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities and Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023 which stated the Proposed FY 2023 Payment Update warrants closer examination and we urge CMS to discuss in the final rule how the agency will account for these increased costs. The timing of this proposed net decrease in payments could not be worse, given the well-documented impact of the COVID-19 public emergency (PHE) on the SNF and nursing home field; Letter sent to the bipartisan, bicameral Leadership of the House and Senate, urging Congress to act to prevent further Medicare sequester cuts scheduled to take effect on July 1; Submitted comment letter about inpatient and long-term care hospital prospective payment system proposed rule for fiscal year 2023. Concerned that CMS is proposing policies and payment adjustment that do not take into account the current the COVID-19 public health emergency (PHE) and its atypical market forces and pandemic-driven aberrations affecting the utilization and cost of providing LTCH services. Specifically, we are concerned by proposals for an inadequate market basket update and an untenable spike in the high-cost outlier threshold; Letter urges Congress to call on CMS to make changes to the hospital inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2023 in order to ensure that Medicare payments for acute care services more accurately reflect the cost of providing hospital care to patients and communities; Support the bipartisan Dear Colleague letters that ask CMS to make critical changes to the hospital inpatient prospective payment system proposed rule for fiscal year (FY) 2023 to more accurately reflect the cost of providing hospital care to patients; Support HR 8487/ S 3173 Improving Seniors Timely Access to Care Act of 2022, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans; Support HR 8747 Assistance for Rural Community Hospitals Act of 2022 or the ARCH Act of 2022, a bill to amend title XVIII of the Social Security Act to extend Medicare-dependent hospital and Medicare low-volume hospital payments; Oppose HR 1330/ S 4130 Patient Access to Higher Quality Health Care Act of 2022, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 8188/ S4449 Saving Access to Laboratory Services Act, a bill to amend title XVIII of the Social Security Act to improve the accuracy of market-based Medicare payment for clinical diagnostic laboratory services, to reduce administrative burdens in the collection of data, and for other purposes.

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; Provide comment letter to OSHA on the re-opening of comments on the Occupational Exposure to COVID-19 Rulemaking in which we urge OSHA not to finalize its rule for occupational exposure to COVID-19. In our comments, we indicate that we continue to oppose establishing new regulations that are not fully aligned with the Centers for Disease Control and Preventions evolving evidence-based guidance. With the constantly evolving, science-based CDC guidance and recommendations, CMS vaccination requirement and existing OSHA general standards, we strongly believe that an inconsistent and overly strict OSHA COVID-19 health care standard is not necessary, would cause confusion and will ultimately lower hospital employees morale and worsen unprecedented personnel shortages in hospitals. It is essential to a well-functioning health care system that only one set of science-based standards be applied to health care providers, and that these standards be aligned across federal agencies; Letter urging Congress to make the expanded tax credits permanent, ensuring millions of low- and middle-income families continue to have access to affordable coverage in 2023 and beyond; Express concerns with the letter to CMS from Congressman Murphy that makes a number of requests for data surrounding the COVID-19 add on payments for hospitals. We are concerned about the questions as they do not take into account the continued needs of the nations hospitals and health systems. Hospitals continue to face numerous challenges, including increased labor and supply costs and workforce shortages. These additional payments have helped to address some but not all of the high costs associated with COVID-19 patient care. The complexity of care is still higher than pre-pandemic levels as measured by length of stay, which further indicates that its still more resource intensive to treat COVID inpatients. In addition, the high costs associated personal protective equipment, isolation measures, and other additional resources are necessary when treating all patients, unless and until it is determined they do not have COVID-19; Submitted a letter to Ways and Means per their request for information on the health care industry and climate change. We support the sustainability efforts while acknowledging that for a variety of reasons, many hospitals and health systems face challenges and barriers to implementing this work, especially while responding to a pandemic; Letter urging HHS to maintain the COVID-19 public health emergency (PHE) until it is clear that the global pandemic has receded and the capabilities authorized by the PHE are no longer necessary. This will help prevent any future surges from threatening the health and safety of patients and the ability of health care professionals to care for them; Long COVID Best Clinical Practices Discussion with the White House Policy Advisor, Office of the COVID-19 Response; Submitted comment letter to the Federal Trade Commission outlining the impact pharmacy benefit managers (PBMs) practices have on the field. Specifically, urging the FTC to increase scrutiny on insured-mandated white bagging policies, as well as the impact of PBM-negotiated rebates and other business practices on the 340B drug discount pricing program and overall drug prices and drug price increases; Submit a comment letter to the Internal Revenue Service for their proposed rule amending how employer coverage affordability would be measured for family members of employees. We advocated for a fix to the current methodology for assessing affordability of employer coverage for family members, often referred to as the family glitch, which is estimated to affect about 5 million individuals. We commend the IRS on proposing to revise the regulation and improve access to health insurance coverage for millions of American families; Concerns S.4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 or the FDASLA Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological product; Comment letter on CMS Radiation Oncology (RO) Model proposed rule. We strongly supports CMS efforts to transform the delivery of cancer care. We also support the original intent of the RO Model, which was to protect access to care by ensuring fair, predictable payment for radiation oncologists. However, this important goal of the original RO Model has been marred by the incorporation of significant payment cuts and substantial administrative burdens for those participating in this mandatory model. As such, the AHA supports CMSs proposal to delay the start date of the RO model from Jan. 1, 2023 to a date to be determined through future rulemaking; Support S. 4352,Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Letter in response to CMS request for guidance on implementing the regulatory requirement for convening providers and facilities exchange information with co-providers and co-facilities to create a comprehensive good faith estimate as part of the implementation of the No Surprises Act. Due to the lack of currently available automated solutions, this process would require a significant manual effort by providers, which would undoubtedly result in the convening provider being unable to meet the short statutory timeframes for delivering good faith estimates to the patients and could also lead to inadvertent errors. AHA has requested an extension in enforcement direction until a technical solution has been identified and implemented; Support HR 7691, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purposes; Letter requesting that HHS, HRSA, and OIG take immediate enforcement action against the now 17 companies that are refusing to honor their obligations under the 340B program; Letter sent to HHS Secretary to discuss how best to ensure prompt repayment to 340B hospitals without penalizing the rest of the hospital field after the U.S. Supreme Court unanimously agreed that HHS outpatient payment cuts to hospitals in the 340B Drug Pricing Program were unlawful. The Courts decision did not determine a remedy for the unlawful payment cuts, instead, it remanded the case to the lower courts to address the proper remedy; Support HR 7084/ S 3983, Protecting and Transforming Cyber Health Care Act of 2022 or the PATCH Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to require, for purposes of ensuring cybersecurity, the inclusion in any premarket submission for a cyber device of information to demonstrate a reasonable assurance of safety and effectiveness throughout the lifecycle of the cyber device, and for other purposes; Submit Comment letter of support for CMS continued focus on strengthening health insurance coverage and ensuring ease of enrollment and limited gaps in coverage, including proposed updates to Medicare enrollment and eligibility rules; Submit letter for oversight hearing on Medicare Advantage (MA) plans expressing concerns about some MA plans inappropriate restrictions on beneficiary access to medically necessary care, including those highlighted in a recent report issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG), and urge Congress to increase its oversight of these plans; Provided feedback on the Senate Finance Committees discussion draft addressing mental health care and telehealth. AHA supports allowing Medicare beneficiaries who seek treatment for mental health disorders to receive their care through audio-only services, removing the requirement for Medicare patients to receive an in-person visit prior to receiving mental health services through telehealth, and expanding beyond physicians and limited non-physician practitioners the types of providers who can deliver and bill for telehealth services; Support HR 8576/ S 4352 Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Support HR 8806 Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Submitted a statement for the record for the Senate Judiciary Subcommittee hearing on Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce. This hearing examines the importance of improving the immigration process in order to help alleviate Americas health care workforce shortage. We encourage Congress to help address domestic health care workforce shortage.

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; Provide comment letter to OSHA on the re-opening of comments on the Occupational Exposure to COVID-19 Rulemaking in which we urge OSHA not to finalize its rule for occupational exposure to COVID-19. In our comments, we indicate that we continue to oppose establishing new regulations that are not fully aligned with the Centers for Disease Control and Preventions evolving evidence-based guidance. With the constantly evolving, science-based CDC guidance and recommendations, CMS vaccination requirement and existing OSHA general standards, we strongly believe that an inconsistent and overly strict OSHA COVID-19 health care standard is not necessary, would cause confusion and will ultimately lower hospital employees morale and worsen unprecedented personnel shortages in hospitals. It is essential to a well-functioning health care system that only one set of science-based standards be applied to health care providers, and that these standards be aligned across federal agencies; Letter urging Congress to make the expanded tax credits permanent, ensuring millions of low- and middle-income families continue to have access to affordable coverage in 2023 and beyond; Express concerns with the letter to CMS from Congressman Murphy that makes a number of requests for data surrounding the COVID-19 add on payments for hospitals. We are concerned about the questions as they do not take into account the continued needs of the nations hospitals and health systems. Hospitals continue to face numerous challenges, including increased labor and supply costs and workforce shortages. These additional payments have helped to address some but not all of the high costs associated with COVID-19 patient care. The complexity of care is still higher than pre-pandemic levels as measured by length of stay, which further indicates that its still more resource intensive to treat COVID inpatients. In addition, the high costs associated personal protective equipment, isolation measures, and other additional resources are necessary when treating all patients, unless and until it is determined they do not have COVID-19; Submitted a letter to Ways and Means per their request for information on the health care industry and climate change. We support the sustainability efforts while acknowledging that for a variety of reasons, many hospitals and health systems face challenges and barriers to implementing this work, especially while responding to a pandemic; Letter urging HHS to maintain the COVID-19 public health emergency (PHE) until it is clear that the global pandemic has receded and the capabilities authorized by the PHE are no longer necessary. This will help prevent any future surges from threatening the health and safety of patients and the ability of health care professionals to care for them; Long COVID Best Clinical Practices Discussion with the White House Policy Advisor, Office of the COVID-19 Response; Submitted comment letter to the Federal Trade Commission outlining the impact pharmacy benefit managers (PBMs) practices have on the field. Specifically, urging the FTC to increase scrutiny on insured-mandated white bagging policies, as well as the impact of PBM-negotiated rebates and other business practices on the 340B drug discount pricing program and overall drug prices and drug price increases; Submit a comment letter to the Internal Revenue Service for their proposed rule amending how employer coverage affordability would be measured for family members of employees. We advocated for a fix to the current methodology for assessing affordability of employer coverage for family members, often referred to as the family glitch, which is estimated to affect about 5 million individuals. We commend the IRS on proposing to revise the regulation and improve access to health insurance coverage for millions of American families; Concerns S.4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 or the FDASLA Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological product; Comment letter on CMS Radiation Oncology (RO) Model proposed rule. We strongly supports CMS efforts to transform the delivery of cancer care. We also support the original intent of the RO Model, which was to protect access to care by ensuring fair, predictable payment for radiation oncologists. However, this important goal of the original RO Model has been marred by the incorporation of significant payment cuts and substantial administrative burdens for those participating in this mandatory model. As such, the AHA supports CMSs proposal to delay the start date of the RO model from Jan. 1, 2023 to a date to be determined through future rulemaking; Support S. 4352,Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Letter in response to CMS request for guidance on implementing the regulatory requirement for convening providers and facilities exchange information with co-providers and co-facilities to create a comprehensive good faith estimate as part of the implementation of the No Surprises Act. Due to the lack of currently available automated solutions, this process would require a significant manual effort by providers, which would undoubtedly result in the convening provider being unable to meet the short statutory timeframes for delivering good faith estimates to the patients and could also lead to inadvertent errors. AHA has requested an extension in enforcement direction until a technical solution has been identified and implemented; Support HR 7691, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purposes; Letter requesting that HHS, HRSA, and OIG take immediate enforcement action against the now 17 companies that are refusing to honor their obligations under the 340B program; Letter sent to HHS Secretary to discuss how best to ensure prompt repayment to 340B hospitals without penalizing the rest of the hospital field after the U.S. Supreme Court unanimously agreed that HHS outpatient payment cuts to hospitals in the 340B Drug Pricing Program were unlawful. The Courts decision did not determine a remedy for the unlawful payment cuts, instead, it remanded the case to the lower courts to address the proper remedy; Support HR 7084/ S 3983, Protecting and Transforming Cyber Health Care Act of 2022 or the PATCH Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to require, for purposes of ensuring cybersecurity, the inclusion in any premarket submission for a cyber device of information to demonstrate a reasonable assurance of safety and effectiveness throughout the lifecycle of the cyber device, and for other purposes; Submit Comment letter of support for CMS continued focus on strengthening health insurance coverage and ensuring ease of enrollment and limited gaps in coverage, including proposed updates to Medicare enrollment and eligibility rules; Submit letter for oversight hearing on Medicare Advantage (MA) plans expressing concerns about some MA plans inappropriate restrictions on beneficiary access to medically necessary care, including those highlighted in a recent report issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG), and urge Congress to increase its oversight of these plans.

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887/ S. 4009, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program; Support H.R. 5425/ S. 1988, Protecting Rural Telehealth Access Act, a bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program; Letter asking Congress to address two important issues by the end of the year: an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect; Letter urging Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act; Support H.R. 5674/ S. 3061Medicare Mental Health Inpatient Equity Act of 2021, 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; Letter to the HHS secretary asking for PHE extension and urging HHS to extend the declaration for at least 90 days; Letter to the HHS secretary asking to renew the COVID-19 PHE; Letter to CMS urging changes to MA prior authorization requirements for PHE; Letter expressing our disappointment that Congress is adjourning for April recess without addressing the needs of hospitals and health systems and urging Congress to act to ensure health care providers have the critical relief, including but not limited to extending the Medicare sequester relief, adding more PRF dollars, and providing flexibility in the repayment terms for Medicare accelerated and advance repayments; Provide comments in response to the (CMS) request for information regarding access to coverage and care in the Medicaid and Childrens Health Insurance Program (CHIP) programs. The critical components for a comprehensive access and coverage strategy for Medicaid and CHIP should include: Robust outreach and enrollment efforts to secure and maintain coverage for eligible individuals and families, as well as ensure beneficiary knowledge of how to use this coverage, Standards to ensure timely and equitable access to quality care, and Provider payments that are sufficient to enable beneficiaries' access to quality care; Provide comments in response to the Department of Homeland Securitys (DHS) proposed rule to codify standards and clarify policies that govern public charge determinations. Public charge determinations assess how likely it is that an individual will become dependent on government assistance (public benefits) for support and subsistence. These policy clarifications are intended to help immigrants and their family members better understand when the use of certain public benefits could impact their future immigration status and address the chilling effects of the now-repealed 2019 public charge final rule. The AHA supports DHSs efforts to clarify policies regarding how public charge determinations are made to help reverse the damaging effects of the repealed 2019 public charge rule; A bill to amend title XIX of the Social Security Act to expand the availability of mental, emotional, and behavioral health services under the Medicaid program; Letter urging Congress to halt further cuts to hospital payments. Need to stop a harmful Medicare payment cut to providers that will go into effect July 1 without congressional action. Specifically, a 1% Medicare sequester cut took effect April 1, and that cut will increase to 2% on July 1 if Congress does not act. This will result in billions of dollars being cut from hospitals and health systems by the end of the year; Submitted comment letter regarding Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2023 and Updates to the IRF Quality Reporting Program. We note that the proposed IRF PPS labor-related share would only modestly shift upward from 72.9% in FY 2022 to 73.2% in FY 2022. AHA is concerned that these changes neither align regarding massive cost growth in recent months and years; Provide Comments on the Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities and Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023 which stated the Proposed FY 2023 Payment Update warrants closer examination and we urge CMS to discuss in the final rule how the agency will account for these increased costs. The timing of this proposed net decrease in payments could not be worse, given the well-documented impact of the COVID-19 public emergency (PHE) on the SNF and nursing home field; Letter sent to the bipartisan, bicameral Leadership of the House and Senate, urging Congress to act to prevent further Medicare sequester cuts scheduled to take effect on July 1; Submitted comment letter about inpatient and long-term care hospital prospective payment system proposed rule for fiscal year 2023. Concerned that CMS is proposing policies and payment adjustment that do not take into account the current the COVID-19 public health emergency (PHE) and its atypical market forces and pandemic-driven aberrations affecting the utilization and cost of providing LTCH services. Specifically, we are concerned by proposals for an inadequate market basket update and an untenable spike in the high-cost outlier threshold; Letter urges Congress to call on CMS to make changes to the hospital inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2023 in order to ensure that Medicare payments for acute care services more accurately reflect the cost of providing hospital care to patients and communities.

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program; Support H.R. 5425/ S. 1988, Protecting Rural Telehealth Access Act, a bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program; Letter asking Congress to address two important issues by the end of the year: an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect; Letter urging Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act; Support H.R. 5674/ S. 3061Medicare Mental Health Inpatient Equity Act of 2021, 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; Letter to the HHS secretary asking for PHE extension and urging HHS to extend the declaration for at least 90 days; Letter to the HHS secretary asking to renew the COVID-19 PHE; Letter to CMS urging changes to MA prior authorization requirements for PHE.

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update.

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Letter opposing CMS interim final rule establishing a Most Favored Nation model and urging the agency to withdraw it immediately and replace it with a serious effort at drug pricing reform; Letter urging CMS to rescind its denial determinations for those hospitals that submitted mid-build exception requests due to the agencys failure to meet the required statutory deadline; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Urged CMS to exercise enforcement discretion with respect to the hospital price transparency rule until the end of the public health emergency; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Comment letter to CMS on the CY 2022 OPPS/ASC Proposed Rule oppose the agencys deep OPPS payment cuts to 340B hospitals and other concerns; Letter to CMS administrator on the mid-build exception audit denials requesting the agency rescind the denials or, if not, establish an informal review process to correct errors in the audit determinations. Further requesting that hospitals be allowed extra time to identify and return any overpayments; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program; Support H.R. 5425/ S. 1988, Protecting Rural Telehealth Access Act, a bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program; Letter asking Congress to address two important issues by the end of the year: an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect; Letter urging Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act; Support H.R. 5674/ S. 3061Medicare Mental Health Inpatient Equity Act of 2021, 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.

Support HR 1319, American Rescue Plan Act of 2021, This bill provides additional relief to address the continued impact of COVID-19 on the economy, public health, state and local governments, individuals, and businesses and more money for the Provider Relief Fund in the reconciliation bill, sequester relief, and advanced Medicare payment loan relief; Continue to monitor the FY 2021 budget to prevent or minimize hospital cuts; Urged the Senate to pass legislation that would stop Medicare cuts to hospitals, physicians and other providers from going into effect early next year. The bill would extend the moratorium on the 2% Medicare sequester cuts until April 1, 2022, reduce the cuts from 2% to 1% from April 1 through June 30, 2022, and stop the 4% statutory Pay-As-You-Go sequester from taking effect early next year. Other provisions in the package would mitigate a separate Medicare payment cut to physicians; delay payment cuts and private payer data reporting requirements for certain hospital laboratories; delay the implementation of the radiation oncology model; and set up a fast-track process in the Senate to allow for a vote to increase the debt limit.

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Letter opposing CMS interim final rule establishing a Most Favored Nation model and urging the agency to withdraw it immediately and replace it with a serious effort at drug pricing reform; Letter urging CMS to rescind its denial determinations for those hospitals that submitted mid-build exception requests due to the agencys failure to meet the required statutory deadline; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Urged CMS to exercise enforcement discretion with respect to the hospital price transparency rule until the end of the public health emergency; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Comment letter to CMS on the CY 2022 OPPS/ASC Proposed Rule oppose the agencys deep OPPS payment cuts to 340B hospitals and other concerns; Letter to CMS administrator on the mid-build exception audit denials requesting the agency rescind the denials or, if not, establish an informal review process to correct errors in the audit determinations. Further requesting that hospitals be allowed extra time to identify and return any overpayments; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program.

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Letter opposing CMS interim final rule establishing a Most Favored Nation model and urging the agency to withdraw it immediately and replace it with a serious effort at drug pricing reform; Letter urging CMS to rescind its denial determinations for those hospitals that submitted mid-build exception requests due to the agencys failure to meet the required statutory deadline; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Urged CMS to exercise enforcement discretion with respect to the hospital price transparency rule until the end of the public health emergency; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models.

Support HR 1319, American Rescue Plan Act of 2021, This bill provides additional relief to address the continued impact of COVID-19 on the economy, public health, state and local governments, individuals, and businesses and more money for the Provider Relief Fund in the reconciliation bill, sequester relief, and advanced Medicare payment loan relief; Continue to monitor the FY 2021 budget to prevent or minimize hospital cuts.

Support HR 1319, American Rescue Plan Act of 2021, This bill provides additional relief to address the continued impact of COVID-19 on the economy, public health, state and local governments, individuals, and businesses and more money for the Provider Relief Fund in the reconciliation bill, sequester relief, and advanced Medicare payment loan relief.

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; Support H.R. 1332 and S.368,Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency; Letter opposing CMS interim final rule establishing a Most Favored Nation model and urging the agency to withdraw it immediately and replace it with a serious effort at drug pricing reform; Letter urging CMS to rescind its denial determinations for those hospitals that submitted mid-build exception requests due to the agencys failure to meet the required statutory deadline; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Urged CMS to exercise enforcement discretion with respect to the hospital price transparency rule until the end of the public health emergency; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021.

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets"; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; Discuss DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes; Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters; Letter to the Federal Reserve System, the Federal Deposit Insurance Corporation and the Office of the Comptroller of the Currency requesting they, as primary federal regulators for insured depository institutions, take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise; Letter to the Secretary of the Treasury and the Federal Reserve Chair of the Board of Governors urging a supplement to the New Main Street Loan Facility term sheet with prompt guidance to ensure that access to this critically-necessary loan facility will be attainable for hospitals without delay; Letter was sent to the SBA urging it to ensure that small- and mid-size public hospitals, including those that have both nonprofit and public designations, are allowed to apply for and receive loans under the newly-authorized SBA Paycheck Protection Program; Letter in response to FEMAs request for input on establishing a voluntary agreement, under the Defense Production Act, of key private sector stakeholders relevant to responding to COVID-19, urging that such an agreement account for the full breadth of COVID-19 medical supply and equipment needs; Support H.R. 6474/S.3838 Healthcare Broadband Expansion During COVID-19 Act, a bill that would provide an additional $2 billion in funding for the FCC Rural Health Care program and increase the subsidy for health care providers from 65 to 85 percent. This legislation also simplifies the program to allow for more efficient application processes and disbursement of much needed funding; Support HR 6654 Emergency COVID-19 Telehealth Response Act, a bill that would codify an expanded list of providers to deliver and bill for telehealth services during the PHE; Support HR 7233Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, a bill that would require the Department of Health and Human Services and the Government Accountability Office (GAO) to conduct studies to provide information about the expanded use of telehealth during the COVID-19 pandemic; Letter to Senate HELP Committee in response to request for feedback on preparing for next pandemic; Discussion about telehealth waivers and flexibilities with HHS; Discussion about CARES provider relief fund distributions with HHS; Oppose HR 6559/ S 3677 COVID-19 Every Worker Protection Act of 2020, a bill to require the Occupational Safety and Health Administration to promulgate an emergency temporary standard to protect employees from occupational exposure to SARS-CoV-2, and for other purposes; Joint letter with ANA urging Congress to act quickly to get needed resources into the health care system, so that hospitals, nurses and physicians responding to COVID-19 are able to continue to provide treatments, front-line health care personnel are able to provide care and patients are able access health care services; Statement to Committee on Ways and Means for the hearing on The Disproportionate Impact of COVID-19 on Communities of Color urging Congress to employ the resources of the National Institute on Minority Health and Health Disparities - which is congressionally-mandated to coordinate the research of the other National Institutes of Healths centers and institutes related to minority health - to research and develop approaches to specifically address the COVID-19 needs of minority populations; Advocate with Congress for full forgiveness of COVID-19 related accelerated payments received by hospitals; Support S 3781Pharmaceutical Accountability, Responsibility, and Transparency (PART) Act, a bill to increase reporting of, help mitigate potential shortages related to, and promote, accountability and transparency for pharmaceuticals and medical devices; Support S 3780 Help Onshore Manufacturing Efficiencies (HOME) for Drugs and Devices Act, a bill to encourage domestic advanced manufacturing of critical drugs and devices in order to address economic, health, and security concerns, combat shortages of critical drugs and devices, and promote increased domestic diversification of, and independence from foreign reliance on, pharmaceutical and medical device supply chains; Support S.3763 Pandemic Responder Service Award Act, a bill to establish the Pandemic Responder Service Award program to express our gratitude to front-line health care workers; Support HR 6788/ S 3599 Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Urged support for joint House and Senate letter to the Administration asking for flexibility for hospitals with respect to J-1 and H-1B visa programs; Letter to Senate Finance Committee to address the important issue of maternal health and the opportunity to provide suggestions regarding how to improve maternal health in this country; Support the Temporary Reciprocity to Ensure Access to Treatment Act, a bill that allows for the temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states; Letter urging the Senate to include in the next COVID-19 relief bill provisions to strengthen the federal response for racial and ethnic minority and marginalized communities, which are disproportionately affected by the pandemic;Letter asking Congress to allocate as part of the next COVID-19 relief package at least an additional $100 billion to the emergency relief fund to provide direct funding to front line health care personnel and providers to continue to respond to this pandemic; Letter sent to HHS urging them to direct HRSA to take action to stop three drug manufacturers from limiting the distribution of 340B drugs to 340B covered entities. These drug manufacturers have taken separate actions to either limit the distribution of 340B drugs or require 340B covered entities provide claims level data for investigatory purposes if that 340B covered entity uses a contract pharmacy arrangement; Letter to the Congressional Leadership asking them to not to include in the next COVID-19 relief package any surprise medical billing legislation - such as a reimbursement rate set in statute - that would further destabilize hospitals finances during the pandemic; Support S 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies Act of 2020 or the GET CARE Act of 2020, a bill to amend the Public Health Service Act to provide for a national campaign to raise awareness of the importance of seeking preventive health services and the utilization of such services; Comment letter addressing concerns on the proposed rule from the Departments of the Treasury, Labor and Health and Human Services that would allow certain grandfathered health plans to increase patient cost-sharing beyond current limits, without losing their grandfathered status; Letter urging the Administration to work with the AHA and Congress to create a future for telehealth that allows not only clinicians, but also hospitals and health systems, to code and bill for virtual services. We further urge CMS and HHS to continue to provide hospitals with the flexibility for annual beneficiary consent to telehealth treatment to be obtained at the same time, and not necessarily before, services are furnished; Support HR 8061,Community Immunity During COVID-19 Act of 2020, a bill that would provide funding to state and local health departments to work with community providers and organizations to increase immunization rates for Advisory Committee on Immunization Practices (ACIP)-recommended vaccines during the COVID-19 public health emergency; Letter again expressing concern with recent actions taken by several major drug manufacturers to limit the distribution of certain 340B drugs to our hospital members. While we understand that the HRSA is further investigating these actions, we urge swift and decisive action to halt these pernicious tactics so as to prevent other manufacturers from following suit; Comment letter outlining our concerns about the ability of hospital systems to distribute provider relief funds among the parent and subsidiaries. HHS published certain FAQs that place problematic restrictions on the use of CARES Act provider relief fund dollars. Specifically, the FAQs restrict the ability of a hospital system to allocate the funds throughout its system where COVID-19 related expenses and lost revenues are occurring; Submitted comments in response to HRSAs RFI on Health Professional Shortage Area (HPSA) scoring. HPSA scores are important for rural hospitals and clinics ability to recruit physicians and other clinicians, namely from the National Health Service Corps (NHSC) program. Letter asking HHS to reinstate the COVID-19 Provider Relief Fund reporting requirements; Support S 4349, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 3595Ensuring Understanding of COVID-19 to Protect Public Health Act, a bill that directs the NIH to conduct a longitudinal study on mild, moderate, and severe cases of COVID-19 on a diverse patient population.

Monitoring the Tax Cuts and Jobs Act, legislation to overhaul the nations tax code that contains several notable provisions affecting hospitals; Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, Executive Compensation; Support HR 3300, Economic Mobility Act of 2019, a bill to amend the Internal Revenue Code of 1986 to provide tax relief for workers and families; Letter requesting that Congress use the employer side payroll tax if they use the tax code to provide this assistance so that all hospitals benefit from that relief. The letter also highlights several bond financing options that should be considered; Support HR 2772, Investing in Our Communities Act, a bill to amend the Internal Revenue Code of 1986 to reinstate advance refunding bonds; Support HR 3967, Municipal Bond Market Support Act of 2019, a bill to amend the Internal Revenue Code of 1986 to permanently modify the limitations on the deduction of interest by financial institutions which hold tax-exempt bonds; Support HR 6886Paycheck Protection Program Flexibility Act of 2020, a bill to amend the Small Business Act and the CARES Act to modify certain provisions related to the forgiveness of loans under the paycheck protection program, to allow recipients of loan forgiveness under the paycheck protection program to defer payroll taxes, and for other purposes; A letter requesting that the Treasury and IRS extend the deadlines for tax-exempt hospitals and health systems to prepare community health needs assessments that occur during the COVID public health emergency; Support HR 7819, Eliminating the Provider Relief Fund Tax Penalties Act of 2020, A bill that would remove an unintentional tax penalty on health care providers who received CARES Act funding under the Public Health and Social Services Emergency Fund. If left unchanged, health providers and for-profit hospitals could face a tax as high as 20% on money intended to support them during this pandemic.

Monitor HR 6800Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act, a bill to make emergency supplemental appropriations for the fiscal year ending September 30, 2020 will help hospitals and health systems serve their communities from the Public Health and Social Services Emergency Fund, accelerated payments and temporary elimination of the Medicare sequestration, among other important provisions during this unprecedented public health crisis; Letter sent requesting funding for health care programs for fiscal year FY 2021 to prevent or minimize hospital cuts; Support of the passing of the Continuing Resolution, which included two important provisions for Americas hospitals and health systems and the patients they serve: relief on Medicare accelerated and advanced payments and a delay of Medicaid Disproportionate Share Hospital (DSH) payment cuts.

Meeting with CMS and HHS OIG to relate continuing methodological issues and other errors with the OIG audits targeting hospitals for potential Medicare overpayments and to urge significant reforms of the auditing process including discontinuing use of extrapolation; Discussions on the work/fixes to the anti-kickback provisions in the Eliminating Kickback in Recovery Act of 2018; Urging FTC to give more weight to the efficiencies with demonstrable benefits for patients and their communities in agency reviews and court challenges of hospital mergers and challenges as this more holistic and balanced view of the merger could diminish pressure to enact additional Certificate of Public Advantage (COPA) legislation, and the need for hospitals to seek COPA in the future and endure the associated regulatory and cost burdens of doing so; Letter requesting that DOJ temporarily suspend enforcement of the Stark Law and Anti-Kickback Statute to enable hospitals and health systems to meet the unique circumstances created by the COVID-19 public health emergency; Urged an expeditious review and release of the Physician Self-Referral and Anti-Kickback Statute final regulations that were submitted by the CMS and the HHS Office of Inspector General in July.

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities; Sent comment letter to CMS about our concerns with the timeline proposed for implementation as well as the potential for penalties for noncompliance within this timeline on the Medicare Program: Electronic Prescribing of Controlled Substances; Sent comment letter on the FY 2021 Inpatient PPS proposed rule addressing CMS proposals related to payer-specific negotiated rate data collection, Medicare DSH payments, CAR T, bad debt, MS-DRG classifications, and quality programs, among other topics. Letter requesting that the CMS delay the implementation of the Appropriate Use Criteria for Advanced Diagnostic Imaging Services program to allow providers the opportunity to implement and test operational changes and acquire the education necessary to achieve compliance with the program; Sent comments to the CMS on the agencys long-term care hospital prospective payment system proposed policy changes and fiscal year 2021 rates; Letter to CMS asking for a delay in the start of repayments associated with the Medicare Accelerated and Advance Payment (AAP) Programs; Letter urging the CMS to continue its suspension of medical review activities throughout the ongoing COVID-19 public health emergency; Letter urging CMS to allow periodic interim payment (PIP) hospitals to carry out their accelerated payment repayment at cost settlement, as was initially communicated by the agency and also request that the agency make alternative repayment approaches available, such as direct payments to the Medicare Administrative Contractor (MAC), for all hospitals; Comment letter on CY 2021 Home Health Prospective Payment System Rate Update proposed rule. While we continue to support the PDGM objective of increasing HH PPS payment accuracy, we remain concerned that CY 2020s large behavioral offset, 4.36%, was implemented on a prospective basis; Letter urging the CMS to withdraw the condition of participation (CoP) that hospitals report daily COVID-19 data and request that CMS immediately release detailed interpretive guidance so hospitals can take the necessary steps to come into compliance; Urged CMS to withdraw its Medicaid fiscal accountability proposed rule from its regulatory agenda because it would "severely curtail the availability of health care services to millions of individuals" and "many of its provisions are not legally permissible."

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; Discuss DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes; Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters; Letter to the Federal Reserve System, the Federal Deposit Insurance Corporation and the Office of the Comptroller of the Currency requesting they, as primary federal regulators for insured depository institutions, take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise; Letter to the Secretary of the Treasury and the Federal Reserve Chair of the Board of Governors urging a supplement to the New Main Street Loan Facility term sheet with prompt guidance to ensure that access to this critically-necessary loan facility will be attainable for hospitals without delay; Letter was sent to the SBA urging it to ensure that small- and mid-size public hospitals, including those that have both nonprofit and public designations, are allowed to apply for and receive loans under the newly-authorized SBA Paycheck Protection Program; Letter in response to FEMAs request for input on establishing a voluntary agreement, under the Defense Production Act, of key private sector stakeholders relevant to responding to COVID-19, urging that such an agreement account for the full breadth of COVID-19 medical supply and equipment needs; Support H.R. 6474/S.3838 Healthcare Broadband Expansion During COVID-19 Act, a bill that would provide an additional $2 billion in funding for the FCC Rural Health Care program and increase the subsidy for health care providers from 65 to 85 percent. This legislation also simplifies the program to allow for more efficient application processes and disbursement of much needed funding; Support HR 6654 Emergency COVID-19 Telehealth Response Act, a bill that would codify an expanded list of providers to deliver and bill for telehealth services during the PHE; Support HR 7233Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, a bill that would require the Department of Health and Human Services and the Government Accountability Office (GAO) to conduct studies to provide information about the expanded use of telehealth during the COVID-19 pandemic; Letter to Senate HELP Committee in response to request for feedback on preparing for next pandemic; Discussion about telehealth waivers and flexibilities with HHS; Discussion about CARES provider relief fund distributions with HHS; Oppose HR 6559/ S 3677 COVID-19 Every Worker Protection Act of 2020, a bill to require the Occupational Safety and Health Administration to promulgate an emergency temporary standard to protect employees from occupational exposure to SARS-CoV-2, and for other purposes; Joint letter with ANA urging Congress to act quickly to get needed resources into the health care system, so that hospitals, nurses and physicians responding to COVID-19 are able to continue to provide treatments, front-line health care personnel are able to provide care and patients are able access health care services; Statement to Committee on Ways and Means for the hearing on The Disproportionate Impact of COVID-19 on Communities of Color urging Congress to employ the resources of the National Institute on Minority Health and Health Disparities - which is congressionally-mandated to coordinate the research of the other National Institutes of Healths centers and institutes related to minority health - to research and develop approaches to specifically address the COVID-19 needs of minority populations; Advocate with Congress for full forgiveness of COVID-19 related accelerated payments received by hospitals; Support S 3781Pharmaceutical Accountability, Responsibility, and Transparency (PART) Act, a bill to increase reporting of, help mitigate potential shortages related to, and promote, accountability and transparency for pharmaceuticals and medical devices; Support S 3780 Help Onshore Manufacturing Efficiencies (HOME) for Drugs and Devices Act, a bill to encourage domestic advanced manufacturing of critical drugs and devices in order to address economic, health, and security concerns, combat shortages of critical drugs and devices, and promote increased domestic diversification of, and independence from foreign reliance on, pharmaceutical and medical device supply chains; Support S.3763 Pandemic Responder Service Award Act, a bill to establish the Pandemic Responder Service Award program to express our gratitude to front-line health care workers; Support HR 6788/ S 3599 Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Urged support for joint House and Senate letter to the Administration asking for flexibility for hospitals with respect to J-1 and H-1B visa programs; Letter to Senate Finance Committee to address the important issue of maternal health and the opportunity to provide suggestions regarding how to improve maternal health in this country; Support the Temporary Reciprocity to Ensure Access to Treatment Act, a bill that allows for the temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states; Letter urging the Senate to include in the next COVID-19 relief bill provisions to strengthen the federal response for racial and ethnic minority and marginalized communities, which are disproportionately affected by the pandemic;Letter asking Congress to allocate as part of the next COVID-19 relief package at least an additional $100 billion to the emergency relief fund to provide direct funding to front line health care personnel and providers to continue to respond to this pandemic; Letter sent to HHS urging them to direct HRSA to take action to stop three drug manufacturers from limiting the distribution of 340B drugs to 340B covered entities. These drug manufacturers have taken separate actions to either limit the distribution of 340B drugs or require 340B covered entities provide claims level data for investigatory purposes if that 340B covered entity uses a contract pharmacy arrangement; Letter to the Congressional Leadership asking them to not to include in the next COVID-19 relief package any surprise medical billing legislation - such as a reimbursement rate set in statute - that would further destabilize hospitals finances during the pandemic; Support S 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies Act of 2020 or the GET CARE Act of 2020, a bill to amend the Public Health Service Act to provide for a national campaign to raise awareness of the importance of seeking preventive health services and the utilization of such services; Comment letter addressing concerns on the proposed rule from the Departments of the Treasury, Labor and Health and Human Services that would allow certain grandfathered health plans to increase patient cost-sharing beyond current limits, without losing their grandfathered status; Letter urging the Administration to work with the AHA and Congress to create a future for telehealth that allows not only clinicians, but also hospitals and health systems, to code and bill for virtual services. We further urge CMS and HHS to continue to provide hospitals with the flexibility for annual beneficiary consent to telehealth treatment to be obtained at the same time, and not necessarily before, services are furnished; Support HR 8061,Community Immunity During COVID-19 Act of 2020, a bill that would provide funding to state and local health departments to work with community providers and organizations to increase immunization rates for Advisory Committee on Immunization Practices (ACIP)-recommended vaccines during the COVID-19 public health emergency; Letter again expressing concern with recent actions taken by several major drug manufacturers to limit the distribution of certain 340B drugs to our hospital members. While we understand that the HRSA is further investigating these actions, we urge swift and decisive action to halt these pernicious tactics so as to prevent other manufacturers from following suit; Comment letter outlining our concerns about the ability of hospital systems to distribute provider relief funds among the parent and subsidiaries. HHS published certain FAQs that place problematic restrictions on the use of CARES Act provider relief fund dollars. Specifically, the FAQs restrict the ability of a hospital system to allocate the funds throughout its system where COVID-19 related expenses and lost revenues are occurring; Submitted comments in response to HRSAs RFI on Health Professional Shortage Area (HPSA) scoring. HPSA scores are important for rural hospitals and clinics ability to recruit physicians and other clinicians, namely from the National Health Service Corps (NHSC) program. Letter asking HHS to reinstate the COVID-19 Provider Relief Fund reporting requirements.

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities.

Monitor HR 6800Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act, a bill to make emergency supplemental appropriations for the fiscal year ending September 30, 2020 will help hospitals and health systems serve their communities from the Public Health and Social Services Emergency Fund, accelerated payments and temporary elimination of the Medicare sequestration, among other important provisions during this unprecedented public health crisis; Letter sent requesting funding for health care programs for fiscal year FY 2021 to prevent or minimize hospital cuts.

Meeting with CMS and HHS OIG to relate continuing methodological issues and other errors with the OIG audits targeting hospitals for potential Medicare overpayments and to urge significant reforms of the auditing process including discontinuing use of extrapolation; Discussions on the work/fixes to the anti-kickback provisions in the Eliminating Kickback in Recovery Act of 2018; Urging FTC to give more weight to the efficiencies with demonstrable benefits for patients and their communities in agency reviews and court challenges of hospital mergers and challenges as this more holistic and balanced view of the merger could diminish pressure to enact additional Certificate of Public Advantage (COPA) legislation, and the need for hospitals to seek COPA in the future and endure the associated regulatory and cost burdens of doing so; Letter requesting that DOJ temporarily suspend enforcement of the Stark Law and Anti-Kickback Statute to enable hospitals and health systems to meet the unique circumstances created by the COVID-19 public health emergency.

Continue to monitor the FY 2019 budget to prevent or minimize hospital cuts.

Meeting with CMS and HHS OIG to relate continuing methodological issues and other errors with the OIG audits targeting hospitals for potential Medicare overpayments and to urge significant reforms of the auditing process including discontinuing use of extrapolation; Discussions on the work/fixes to the anti-kickback provisions in the Eliminating Kickback in Recovery Act of 2018; Urging FTC to give more weight to the efficiencies with demonstrable benefits for patients and their communities in agency reviews and court challenges of hospital mergers and challenges as this more holistic and balanced view of the merger could diminish pressure to enact additional Certificate of Public Advantage (COPA) legislation, and the need for hospitals to seek COPA in the future and endure the associated regulatory and cost burdens of doing so.

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Comment letter urged CMS to extend the comment period for the proposed rules related to interoperability provisions of the 21st Century Cures Act by at least 30 days; Comment letter on the Food and Drug Administrations (FDA) draft guidance on blood glucose monitoring test systems (BGMS) for prescription point-of-care (POC) use and urge FDA to consider compiling a finite list of universally acceptable disinfectant products that would apply to all medical devices or classes of device; Comment letter that urged CMS to address the substantial flaws in the star ratings methodology since the ratings inception in 2016 and to suspend the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings; Comment letter to FDA on the public meeting, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions with the following legislative recommendations: Strengthen manufacturers drug shortage disclosure requirements, Incentivize manufacturing contingency plans and/or redundancies, Enhance production transparency requirements, Enact shortage disclosure notification requirements for certain medical devices needed to administer drugs, Assess drug shortages as a national security threat, Include potential risk for drug shortages as a factor in the Federal Trade Commission (FTC) reviews of drug company merger proposals, and regulatory recommendations: Establish incentives to encourage manufacturers to produce drugs in shortage, Prevent manufacturing shutdowns, Establish a quality manufacturing initiative, Enhance information on the quality of outsourcing facilities compounding, Expand and improve the FDAs drug shortages list, Develop a list of critical drugs, Consider how reducing the number of unapproved drugs1 on the market might impact shortages, Reduce drug waste, Create an Office of Clinical Affairs within the Drug Enforcement Administration (DEA); Comment letter urging the CMS to use its upcoming proposed rules for Inpatient Rehabilitation Facility (IRF) and other post-acute care providers to address several issues related to the implementation of the revised case-mix grouping (CMG) policies; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Support letter for the adoption of a unique patient identifier (UPI, by removing the prohibition on the use of federal funds to promulgate or adopt a national UPI would provide HHS the ability to explore solutions that link patients with their correct medical records; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes. Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President today asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters.

Monitoring the Tax Cuts and Jobs Act, legislation to overhaul the nations tax code that contains several notable provisions affecting hospitals; Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, Executive Compensation; Support HR 3300, Economic Mobility Act of 2019, a bill to amend the Internal Revenue Code of 1986 to provide tax relief for workers and families.

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Letter urging the Centers for Medicare & Medicaid Services (CMS)to consider alternative payment solutions for Chimeric Antigen Receptor T-cell (CAR T) therapy; Joint letter urging Congress to delay the start of the Medicaid disproportionate share hospital (DSH) cuts, which are scheduled to begin in fiscal year (FY) 2020; Comments to CMS on exploring ways continually to improve the Medicaid managed care program to ensure access to high-quality care for the Medicaid population; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes.

Meeting with CMS and HHS OIG to relate continuing methodological issues and other errors with the OIG audits targeting hospitals for potential Medicare overpayments and to urge significant reforms of the auditing process including discontinuing use of extrapolation; Discussions on the work/fixes to the anti-kickback provisions in the Eliminating Kickback in Recovery Act of 2018; Urging FTC to give more weight to the efficiencies with demonstrable benefits for patients and their communities in agency reviews and court challenges of hospital mergers and challenges as this more holistic and balanced view of the merger could diminish pressure to enact additional Certificate of Public Advantage (COPA) legislation, and the need for hospitals to seek COPA in the future and endure the associated regulatory and cost burdens of doing so.

Continue to monitor the FY 2019 budget to prevent or minimize hospital cuts.

Monitoring the Tax Cuts and Jobs Act, legislation to overhaul the nations tax code that contains several notable provisions affecting hospitals; Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, Executive Compensation; Support HR 3300, Economic Mobility Act of 2019, a bill to amend the Internal Revenue Code of 1986 to provide tax relief for workers and families.

Meeting with CMS and HHS OIG to relate continuing methodological issues and other errors with the OIG audits targeting hospitals for potential Medicare overpayments and to urge significant reforms of the auditing process including discontinuing use of extrapolation; Discussions on the work/fixes to the anti-kickback provisions in the Eliminating Kickback in Recovery Act of 2018; Urging FTC to give more weight to the efficiencies with demonstrable benefits for patients and their communities in agency reviews and court challenges of hospital mergers and challenges as this more holistic and balanced view of the merger could diminish pressure to enact additional Certificate of Public Advantage (COPA) legislation, and the need for hospitals to seek COPA in the future and endure the associated regulatory and cost burdens of doing so.

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Letter urging the Centers for Medicare & Medicaid Services (CMS)to consider alternative payment solutions for Chimeric Antigen Receptor T-cell (CAR T) therapy; Joint letter urging Congress to delay the start of the Medicaid disproportionate share hospital (DSH) cuts, which are scheduled to begin in fiscal year (FY) 2020; Comments to CMS on exploring ways continually to improve the Medicaid managed care program to ensure access to high-quality care for the Medicaid population; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans.

Monitoring the Tax Cuts and Jobs Act, legislation to overhaul the nations tax code that contains several notable provisions affecting hospitals; Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, Executive Compensation; Support HR 3300, Economic Mobility Act of 2019, a bill to amend the Internal Revenue Code of 1986 to provide tax relief for workers and families.

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Comment letter urged CMS to extend the comment period for the proposed rules related to interoperability provisions of the 21st Century Cures Act by at least 30 days; Comment letter on the Food and Drug Administrations (FDA) draft guidance on blood glucose monitoring test systems (BGMS) for prescription point-of-care (POC) use and urge FDA to consider compiling a finite list of universally acceptable disinfectant products that would apply to all medical devices or classes of device; Comment letter that urged CMS to address the substantial flaws in the star ratings methodology since the ratings inception in 2016 and to suspend the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings; Comment letter to FDA on the public meeting, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions with the following legislative recommendations: Strengthen manufacturers drug shortage disclosure requirements, Incentivize manufacturing contingency plans and/or redundancies, Enhance production transparency requirements, Enact shortage disclosure notification requirements for certain medical devices needed to administer drugs, Assess drug shortages as a national security threat, Include potential risk for drug shortages as a factor in the Federal Trade Commission (FTC) reviews of drug company merger proposals, and regulatory recommendations: Establish incentives to encourage manufacturers to produce drugs in shortage, Prevent manufacturing shutdowns, Establish a quality manufacturing initiative, Enhance information on the quality of outsourcing facilities compounding, Expand and improve the FDAs drug shortages list, Develop a list of critical drugs, Consider how reducing the number of unapproved drugs1 on the market might impact shortages, Reduce drug waste, Create an Office of Clinical Affairs within the Drug Enforcement Administration (DEA); Comment letter urging the CMS to use its upcoming proposed rules for Inpatient Rehabilitation Facility (IRF) and other post-acute care providers to address several issues related to the implementation of the revised case-mix grouping (CMG) policies; Letter sent to the Congressional Telehealth Caucus with recommendations to improve and expand access to telehealth; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft has our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes Concerns S 1531 Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019A bill to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Submitted oral and written testimony to the Senate Committee on Health, Education, Labor and Pensions Hearing: Lower Health Care Costs Act Concerns about several proposals that would allow the government to intrude into private commercial contracts between providers and insurers, which could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs and the impact on rural communities. We strongly urge the Committee to remove these provisions; Concerns S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425Advancing Medical Resident Training in Community Hospitals Act of 2019A bill to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations.

Monitoring the Tax Cuts and Jobs Act, legislation to overhaul the nations tax code that contains several notable provisions affecting hospitals; Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, Executive Compensation.

Meeting with CMS and HHS OIG to relate continuing methodological issues and other errors with the OIG audits targeting hospitals for potential Medicare overpayments and to urge significant reforms of the auditing process including discontinuing use of extrapolation; Discussions on the work/fixes to the anti-kickback provisions in the Eliminating Kickback in Recovery Act of 2018.

Continue to monitor the FY 2019 budget to prevent or minimize hospital cuts.

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Comment letter urged CMS to extend the comment period for the proposed rules related to interoperability provisions of the 21st Century Cures Act by at least 30 days; Comment letter on the Food and Drug Administrations (FDA) draft guidance on blood glucose monitoring test systems (BGMS) for prescription point-of-care (POC) use and urge FDA to consider compiling a finite list of universally acceptable disinfectant products that would apply to all medical devices or classes of device; Comment letter that urged CMS to address the substantial flaws in the star ratings methodology since the ratings inception in 2016 and to suspend the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings; Comment letter to FDA on the public meeting, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions with the following legislative recommendations: Strengthen manufacturers drug shortage disclosure requirements, Incentivize manufacturing contingency plans and/or redundancies, Enhance production transparency requirements, Enact shortage disclosure notification requirements for certain medical devices needed to administer drugs, Assess drug shortages as a national security threat, Include potential risk for drug shortages as a factor in the Federal Trade Commission (FTC) reviews of drug company merger proposals, and regulatory recommendations: Establish incentives to encourage manufacturers to produce drugs in shortage, Prevent manufacturing shutdowns, Establish a quality manufacturing initiative, Enhance information on the quality of outsourcing facilities compounding, Expand and improve the FDAs drug shortages list, Develop a list of critical drugs, Consider how reducing the number of unapproved drugs1 on the market might impact shortages, Reduce drug waste, Create an Office of Clinical Affairs within the Drug Enforcement Administration (DEA); Comment letter urging the CMS to use its upcoming proposed rules for Inpatient Rehabilitation Facility (IRF) and other post-acute care providers to address several issues related to the implementation of the revised case-mix grouping (CMG) policies.

Monitoring the development and release of the FY 2018 budget to prevent or minimize hospital cuts.

In support of current hospital tax exemption and 501(c)(3) private activity bonds; Monitored the Tax Cuts and Jobs Act legislation to overhaul the nations tax code that contained several notable provisions affecting hospitals, such as the Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, and Executive Compensation; Support the legislation to restore the tax exemption for advance refunding bonds that was repealed in the Tax Cuts and Jobs Act.

Discussed, S. 744, The Protecting Veterans Credit Act of 2017 with the bill author about issues related to the inclusion in consumer credit reports and establishment of requirements for debt collectors with respect to medical debt information of veterans due to inappropriate or delayed billing payments or reimbursements from the Department of Veterans Affairs; Raised concerns that the DOL proposed rule modifying the definition of "employers" under ERISA in order to expand access to association health plans (AHPs)would fail to protect against discriminatory insurance practices and could contribute to instability in the individual and small group market, ultimately decreasing access to affordable coverage.

Support H.R. 659, The Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act of 2017, a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority and discussed the companion legislation with the Senate; Urged changes to reduce paperwork burdens and ease implementation of the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) proposed rule regarding certain statutory conscience protections; Submitted a statement to the House Committee on Ways and Means, Subcommittee on Health on Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program; Working with HHS to address EMTALA issues related to behavioral health patients awaiting state confirmation of bed availability in state psychiatric hospital for patient transfer.

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.

Support H.R. 659, The Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act of 2017, a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority and discussed the companion legislation with the Senate; Urged changes to reduce paperwork burdens and ease implementation of the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) proposed rule regarding certain statutory conscience protections; Submitted a statement to the House Committee on Ways and Means, Subcommittee on Health on Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program; Working with HHS to address EMTALA issues related to behavioral health patients awaiting state confirmation of bed availability in state psychiatric hospital for patient transfer.

Support H.R. 304/S. 916, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156/ S 1133 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, 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; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support HR 2141/ S 898, the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care; Support S.781/ HR 1876. Good Samaritan Health Professional Act of 2017, a bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster; Support HR 2212/ S 974Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2017, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Meet with HRSA Administrator and senior staff on 340B drug pricing program; Discussed marketplace stabilization solutions with Hill staff; Support and Recommend changes to HR 1253, Mental Health and Substance Abuse Treatment Accessibility Act of 2017a bill to authorize the Secretary of Health and Human Services to make loans and loan guarantees for constructing or renovating, or planning construction or renovation of, qualified psychiatric and substance abuse treatment facilities, and for other purposes: advocated for changes to clarify/expand the entities that can be loan applicants/recipients; Urged the Administration to suspend the faulty star ratings from the Hospital Compare website; Eliminate barriers to care with the creation of an Anti-Kickback safe harbor for clinical integration arrangements that establishes the basic accountabilities for the use of incentive payment or shared savings programs among hospitals, physicians and other providers, along with a safe-harbor for assistance to patients that would protect providers from financial penalties under the Civil Monetary Penalties (CMPs) for providing an inducement to a patient; Advocated for changes including: eliminating geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; and covering all services that are safe to provide, rather than a small list of approved services; Submit Statement Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care Stakeholders about the importance of stabilizing the Health Insurance Marketplaces for 2018 and beyond; We urged Congress to pass legislation to fund the ACA cost-sharing reductions; Urged Senators to oppose the Graham-Cassidy proposal being considered in the Senate because this proposal would make significant changes to health care coverage and health care financing; Review of H.R. 3528, Every Prescription Conveyed Securely Act, a bill to amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances; Discussions with Congress on prescription drug monitoring programs, the dispensing of controlled substances, and clinical workflow; Discussions with Congress on draft legislation related to prescription drug monitoring programs; Urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer; Review of The Combating the Opioid Epidemic Act, a bill to provide funding to combat the opioid epidemic; Discussions with the White House/Office of National Drug Control Policy about the opioid epidemic, including concerns about regulations that prohibit the sharing of substance use disorder records among health care providers; Support H.R. 4392 a bill to prevent cuts to the 340B drug savings program, which would provide relief from deep cuts to payments to hospitals participating in the 340B program; Letter to congress outlining AHA opposition to a potential policy that would cut payments to hospitals treating hospice patients; Oppose H.R. 4710, 340B Protecting Access for the Underserved and Safety-Net Entities (PAUSE) Act, a bill to amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated site; Sent comments to the Energy and Commerce Subcommittee on Oversight and Investigations for its hearing on Examining the Impact of Health Care Consolidation.; Letter sent to the Energy & Commerce Subcommittee for its hearing on, "Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety"; Letter submitted to the Ways and Means Committee on policy recommendations to address the opioid epidemic; Sent letter to discuss the current state of health care costs, and efforts to increase transparency in the pricing of health care services and the quality of care; Addressed our concerns with the MedPAC Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Addressed our concerns with the Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Support HR4776, Hospital Preparedness Reauthorization Act of 2018, a bill to amend the Public Health Service Act to reauthorize a program of partnerships for State and regional hospital preparedness to improve surge capacity and would increase the level of authorized funding for the Hospital Preparedness Program to $515 million; Submitted statement to the Senate HELP Committee on the Hearing on How to Reduce Health Care Costs: Understanding the Cost of Health Care in America; Submitted a Statement for the HELP hearing on Effective Administration of the 340B Drug Pricing Program; Support certain provisions in Helping to End Addiction and Lesson (HEAL) Substance Use Disorders Act of 2018; Support HR 6071, Stretching Entity Resources for Vulnerable Communities Act or the SERV Communities Act, A bill to amend the Public Health Service Act to clarify the intent of the 340B program and provide for enhanced 340B program integrity; Support S 2597Childrens Hospital GME Support Reauthorization Act of 2018, A bill to amend the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs; Support HR 3545, Overdose Prevention and Patient Safety ActA bill to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records; Support S 2516, Alternatives to Opioids (ALTO) in the Emergency Department ActA bill to direct the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in emergency departments; Support HR 5176/ S 2610, Preventing Overdoses While in Emergency Rooms Act of 2018 A bill to require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge; Submit statement to the Ways and Means Subcommittee on Health on the hearing Identifying Innovative Practices and Technology in Health Care; Support S 1845 Lead-Safe Housing for Kids Act" To amend the Lead-Based Paint Poisoning Prevention Act to provide for additional procedures for families with children under the age of 6; Submitted statement to the Energy & Commerce Health Subcommittee for the hearing "Improving the Coordination and Quality of Substance Use Disorder Treatment." The statement focuses on 42 CFR Part 2; Comments to HELP Committee's discussion draft of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018; The current Pandemic and All-Hazards Preparedness Act (PAHPA) will sunset on October 1, 2018 so this is "must-do" legislation; Support S 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI), A bill to reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act; Supports S. 2372, VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act of 2018).A bill to establish a permanent community care program for veterans, to establish a commission for the purpose of making recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration, to improve construction of the Department of Veterans Affairs, to make certain improvements in the laws administered by the Secretary of Veterans Affairs relating to the home loan program of the Department of Veterans Affairs,Submitted a statement to the Ways and Means Committee hearing on "Lowering Costs and Expanding Access to Health Care through Consumer-Directed Health Plans;" Submitted a statement to the Senate HELP Subcommittee on "Primary Health and Retirement Security on Health Care in Rural America: Examining Experiences and Costs"; Submitted a statement to the Senate HELP Committee on "Reducing Health Care Costs: Eliminating Excess Health Care Spending and Improving Quality and Value for Patients"; Submitted comments on the consumer-directed health plan legislation to the Committee on Ways & Means; Submitted a statement to the Energy and Commerce Subcommittee on Health on "Opportunities to Improve the 340B Drug Pricing Program".

Monitoring the development and release of the FY 2018 budget to prevent or minimize hospital cuts.

In support of current hospital tax exemption and 501(c)(3) private activity bonds; Monitored the Tax Cuts and Jobs Act legislation to overhaul the nations tax code that contained several notable provisions affecting hospitals, such as the Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, and Executive Compensation; Support the legislation to restore the tax exemption for advance refunding bonds that was repealed in the Tax Cuts and Jobs Act.

Support H.R. 304/S. 916, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156/ S 1133 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, 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; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support HR 2141/ S 898, the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care; Support S.781/ HR 1876. Good Samaritan Health Professional Act of 2017, a bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster; Support HR 2212/ S 974Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2017, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Meet with HRSA Administrator and senior staff on 340B drug pricing program; Discussed marketplace stabilization solutions with Hill staff; Support and Recommend changes to HR 1253, Mental Health and Substance Abuse Treatment Accessibility Act of 2017a bill to authorize the Secretary of Health and Human Services to make loans and loan guarantees for constructing or renovating, or planning construction or renovation of, qualified psychiatric and substance abuse treatment facilities, and for other purposes: advocated for changes to clarify/expand the entities that can be loan applicants/recipients; Urged the Administration to suspend the faulty star ratings from the Hospital Compare website; Eliminate barriers to care with the creation of an Anti-Kickback safe harbor for clinical integration arrangements that establishes the basic accountabilities for the use of incentive payment or shared savings programs among hospitals, physicians and other providers, along with a safe-harbor for assistance to patients that would protect providers from financial penalties under the Civil Monetary Penalties (CMPs) for providing an inducement to a patient; Advocated for changes including: eliminating geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; and covering all services that are safe to provide, rather than a small list of approved services; Submit Statement Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care Stakeholders about the importance of stabilizing the Health Insurance Marketplaces for 2018 and beyond; We urged Congress to pass legislation to fund the ACA cost-sharing reductions; Urged Senators to oppose the Graham-Cassidy proposal being considered in the Senate because this proposal would make significant changes to health care coverage and health care financing; Review of H.R. 3528, Every Prescription Conveyed Securely Act, a bill to amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances; Discussions with Congress on prescription drug monitoring programs, the dispensing of controlled substances, and clinical workflow; Discussions with Congress on draft legislation related to prescription drug monitoring programs; Urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer; Review of The Combating the Opioid Epidemic Act, a bill to provide funding to combat the opioid epidemic; Discussions with the White House/Office of National Drug Control Policy about the opioid epidemic, including concerns about regulations that prohibit the sharing of substance use disorder records among health care providers; Support H.R. 4392 a bill to prevent cuts to the 340B drug savings program, which would provide relief from deep cuts to payments to hospitals participating in the 340B program; Letter to congress outlining AHA opposition to a potential policy that would cut payments to hospitals treating hospice patients; Oppose H.R. 4710, 340B Protecting Access for the Underserved and Safety-Net Entities (PAUSE) Act, a bill to amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated site; Sent comments to the Energy and Commerce Subcommittee on Oversight and Investigations for its hearing on Examining the Impact of Health Care Consolidation.; Letter sent to the Energy & Commerce Subcommittee for its hearing on, "Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety"; Letter submitted to the Ways and Means Committee on policy recommendations to address the opioid epidemic; Sent letter to discuss the current state of health care costs, and efforts to increase transparency in the pricing of health care services and the quality of care; Addressed our concerns with the MedPAC Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Addressed our concerns with the Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Support HR4776, Hospital Preparedness Reauthorization Act of 2018, a bill to amend the Public Health Service Act to reauthorize a program of partnerships for State and regional hospital preparedness to improve surge capacity and would increase the level of authorized funding for the Hospital Preparedness Program to $515 million; Submitted statement to the Senate HELP Committee on the Hearing on How to Reduce Health Care Costs: Understanding the Cost of Health Care in America; Submitted a Statement for the HELP hearing on Effective Administration of the 340B Drug Pricing Program; Support certain provisions in Helping to End Addiction and Lesson (HEAL) Substance Use Disorders Act of 2018; Support HR 6071, Stretching Entity Resources for Vulnerable Communities Act or the SERV Communities Act, A bill to amend the Public Health Service Act to clarify the intent of the 340B program and provide for enhanced 340B program integrity; Support S 2597Childrens Hospital GME Support Reauthorization Act of 2018, A bill to amend the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs; Support HR 3545, Overdose Prevention and Patient Safety ActA bill to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records; Support S 2516, Alternatives to Opioids (ALTO) in the Emergency Department ActA bill to direct the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in emergency departments; Support HR 5176/ S 2610, Preventing Overdoses While in Emergency Rooms Act of 2018 A bill to require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge; Submit statement to the Ways and Means Subcommittee on Health on the hearing Identifying Innovative Practices and Technology in Health Care; Support S 1845 Lead-Safe Housing for Kids Act" To amend the Lead-Based Paint Poisoning Prevention Act to provide for additional procedures for families with children under the age of 6; Submitted statement to the Energy & Commerce Health Subcommittee for the hearing "Improving the Coordination and Quality of Substance Use Disorder Treatment." The statement focuses on 42 CFR Part 2; Comments to HELP Committee's discussion draft of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018; The current Pandemic and All-Hazards Preparedness Act (PAHPA) will sunset on October 1, 2018 so this is "must-do" legislation; Support S 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI), A bill to reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act; Supports S. 2372, VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act of 2018).A bill to establish a permanent community care program for veterans, to establish a commission for the purpose of making recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration, to improve construction of the Department of Veterans Affairs, to make certain improvements in the laws administered by the Secretary of Veterans Affairs relating to the home loan program of the Department of Veterans Affairs,Submitted a statement to the Ways and Means Committee hearing on "Lowering Costs and Expanding Access to Health Care through Consumer-Directed Health Plans."

Monitoring the development and release of the FY 2018 budget to prevent or minimize hospital cuts.

Support H.R. 659, The Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act of 2017, a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority and discussed the companion legislation with the Senate; Urged changes to reduce paperwork burdens and ease implementation of the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) proposed rule regarding certain statutory conscience protections.

Discussed, S. 744, The Protecting Veterans Credit Act of 2017 with the bill author about issues related to the inclusion in consumer credit reports and establishment of requirements for debt collectors with respect to medical debt information of veterans due to inappropriate or delayed billing payments or reimbursements from the Department of Veterans Affairs; Raised concerns that the DOL proposed rule modifying the definition of "employers" under ERISA in order to expand access to association health plans (AHPs)would fail to protect against discriminatory insurance practices and could contribute to instability in the individual and small group market, ultimately decreasing access to affordable coverage.

Discussed, S. 744, The Protecting Veterans Credit Act of 2017 with the bill author about issues related to the inclusion in consumer credit reports and establishment of requirements for debt collectors with respect to medical debt information of veterans due to inappropriate or delayed billing payments or reimbursements from the Department of Veterans Affairs; Raised concerns that the DOL proposed rule modifying the definition of "employers" under ERISA in order to expand access to association health plans (AHPs)would fail to protect against discriminatory insurance practices and could contribute to instability in the individual and small group market, ultimately decreasing access to affordable coverage.

In support of current hospital tax exemption and 501(c)(3) private activity bonds; Monitored the Tax Cuts and Jobs Act legislation to overhaul the nations tax code that contained several notable provisions affecting hospitals, such as the Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, and Executive Compensation; Support the legislation to restore the tax exemption for advance refunding bonds that was repealed in the Tax Cuts and Jobs Act.

Support H.R. 659, The Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act of 2017, a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority and discussed the companion legislation with the Senate; Urged changes to reduce paperwork burdens and ease implementation of the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) proposed rule regarding certain statutory conscience protections.

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.

Discussed, S. 744, The Protecting Veterans Credit Act of 2017 with the bill author about issues related to the inclusion in consumer credit reports and establishment of requirements for debt collectors with respect to medical debt information of veterans due to inappropriate or delayed billing payments or reimbursements from the Department of Veterans Affairs.

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 2017A 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; Submit Statement for Medicare Advantage Hearing on Promoting Integrated and Coordinated Care for Medicare Beneficiaries on the importance of promoting integrated and coordinated care for Medicare beneficiaries served through the Medicare Advantage (MA) 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/ S. xxx,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.

Support H.R. 304/S. 916, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, 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; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support HR 2141/ S 898, the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care; Support S.781/ HR 1876. Good Samaritan Health Professional Act of 2017, a bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster; Support HR 2212/ S 974Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2017, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; opposition to S. 1133 Patient Access to Higher Quality Health Care Act of 2017,a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support a resolution promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2017 submit for the record our comments on information security in the health care field; Meet with HRSA Administrator and senior staff on 340B drug pricing program; Discussed marketplace stabilization solutions with Hill staff; Support and Recommend changes to HR 1253, Mental Health and Substance Abuse Treatment Accessibility Act of 2017a bill to authorize the Secretary of Health and Human Services to make loans and loan guarantees for constructing or renovating, or planning construction or renovation of, qualified psychiatric and substance abuse treatment facilities, and for other purposes: advocated for changes to clarify/expand the entities that can be loan applicants/recipients; Urged the Administration to suspend the faulty star ratings from the Hospital Compare website; Eliminate barriers to care with the creation of an Anti-Kickback safe harbor for clinical integration arrangements that establishes the basic accountabilities for the use of incentive payment or shared savings programs among hospitals, physicians and other providers, along with a safe-harbor for assistance to patients that would protect providers from financial penalties under the Civil Monetary Penalties (CMPs) for providing an inducement to a patient; Advocated for changes including: eliminating geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; and covering all services that are safe to provide, rather than a small list of approved services; Submit Statement Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care Stakeholders about the importance of stabilizing the Health Insurance Marketplaces for 2018 and beyond; We urged Congress to pass legislation to fund the cost-sharing reductions; Urged Senators to oppose the Graham-Cassidy proposal being considered in the Senate because this proposal would make significant changes to health care coverage and health care financing; Review of H.R. 3528, Every Prescription Conveyed Securely Act, a bill to amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances; Discussions with Congress on prescription drug monitoring programs, the dispensing of controlled substances, and clinical workflow; Discussions with Congress on draft legislation related to prescription drug monitoring programs; Urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer; Review of The Combating the Opioid Epidemic Act, a bill to provide funding to combat the opioid epidemic; Discussions with the White House/Office of National Drug Control Policy about the opioid epidemic, including concerns about regulations that prohibit the sharing of substance use disorder records among health care providers; Support H.R. 4392 a bill to prevent cuts to the 340B drug savings program, which would provide relief from deep cuts to payments to hospitals participating in the 340B program; Letter to congress outlining AHA opposition to a potential policy that would cut payments to hospitals treating hospice patients.

Monitoring the development and release of the FY 2018 budget to prevent or minimize hospital cuts.

In support of current hospital tax exemption and 501(c)(3) private activity bonds.

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 2017A 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; Submit StatementMedicare Advantage Hearing on Promoting Integrated and Coordinated Care for Medicare Beneficiaries the importance of promoting integrated and coordinated care for Medicare eneficiaries served through the Medicare Advantage (MA) 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/ S. xxx,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; Urges 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; CMS should 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.

Discussed, S. 744, The Protecting Veterans Credit Act of 2017 with the bill authorTo amend the Fair Credit Reporting Act to delay the inclusion in consumer credit reports and to establish requirements for debt collectors with respect to medical debt information of veterans due to inappropriate or delayed billing payments or reimbursements from the Department of Veterans Affairs.

Support H.R. 659, The Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act of 2017, a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority and discussed the companion legislation with the 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 2017A 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; Submit StatementMedicare Advantage Hearing on Promoting Integrated and Coordinated Care for Medicare Beneficiaries the importance of promoting integrated and coordinated care for Medicare eneficiaries served through the Medicare Advantage (MA) 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/ S. xxx,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; Urges 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; CMS should 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.

In support of current hospital tax exemption and 501(c)(3) private activity bonds.

In support of current hospital tax exemption and 501(c)(3) private activity bonds.

Monitoring the development and release of the FY 2018 budget to prevent or minimize hospital cuts.

Discussed, S. 744, The Protecting Veterans Credit Act of 2017 with the bill authorTo amend the Fair Credit Reporting Act to delay the inclusion in consumer credit reports and to establish requirements for debt collectors with respect to medical debt information of veterans due to inappropriate or delayed billing payments or reimbursements from the Department of Veterans Affairs.

Support H.R. 304, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, 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; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care.

Urging reconfiguration of Schedule H to include on the forms first page the value of hospitals contribution related to housing services as community benefit. Supporting preservation of tax exempt status for hospitals. Opposing requirement that hospitals provide to patients a detailed list of all the individual providers that are covered by the individual hospitals financial assistance policy to satisfy the obligation under 501(r) of the Code. Urging issuance of more detailed instructions for completing schedule H; Support H.R.2229 - Municipal Bond Market Support Act of 2015, Amends Internal Revenue Code provisions relating to the small issuer exemption from interest expense allocation rules for financial institutions to: (1) permanently increase from $10 million to $30 million the annual limit on the amount of tax-exempt obligations that a small issuer may issue, and (2) allow an inflation adjustment to such increased limit amount after 2015; Support S.3257 - A bill to amend the Internal Revenue Code of 1986 to permanently modify the limitations on the deduction of interest by financial institutions which hold tax-exempt bonds, and for other purposes.

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services to veterans under S. 759. Enhancing Veteran's Care Through the Veteran Care Agreements Act of 2015; Outlining hospitals views of the barriers, obstacles to EHR interoperability; Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement.

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI; Support Appropriations measures related to funding of our health care priorities (eg. nurse education, rural health, hospital preparedness, etc).

Urging reconfiguration of Schedule H to include on the forms first page the value of hospitals contribution related to housing services as community benefit. Supporting preservation of tax exempt status for hospitals. Opposing requirement that hospitals provide to patients a detailed list of all the individual providers that are covered by the individual hospitals financial assistance policy to satisfy the obligation under 501(r) of the Code. Urging issuance of more detailed instructions for completing schedule H.

Supporting HJ Res 29 and SJ Res. 8 to nullify NLRBs expedited union elections rule; Opposing NLRBs change in standards for determining joint employer status; Support the H.R. 2745, Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER Act), a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority; Urged that attention be payed to the anti-competitive effects and consumer harms in the Anthem / Cigna deal that result from the BCBS affiliation of Anthem.

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services to veterans under S. 759. Enhancing Veteran's Care Through the Veteran Care Agreements Act of 2015; Outlining hospitals views of the barriers, obstacles to EHR interoperability; Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement.

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services to veterans under S. 759. Enhancing Veteran's Care Through the Veteran Care Agreements Act of 2015; Outlining hospitals views of the barriers, obstacles to EHR interoperability; Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement.

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI; Support Appropriations measures related to funding of our health care priorities (eg. nurse education, rural health, hospital preparedness, etc).

Urging reconfiguration of Schedule H to include on the forms first page the value of hospitals contribution related to housing services as community benefit. Supporting preservation of tax exempt status for hospitals. Opposing requirement that hospitals provide to patients a detailed list of all the individual providers that are covered by the individual hospitals financial assistance policy to satisfy the obligation under 501(r) of the Code. Urging issuance of more detailed instructions for completing schedule H; Support H.R.2229 - Municipal Bond Market Support Act of 2015, Amends Internal Revenue Code provisions relating to the small issuer exemption from interest expense allocation rules for financial institutions to: (1) permanently increase from $10 million to $30 million the annual limit on the amount of tax-exempt obligations that a small issuer may issue, and (2) allow an inflation adjustment to such increased limit amount after 2015; Support S.3257 - A bill to amend the Internal Revenue Code of 1986 to permanently modify the limitations on the deduction of interest by financial institutions which hold tax-exempt bonds, and for other purposes.

Supporting HJ Res 29 and SJ Res. 8 to nullify NLRBs expedited union elections rule; Opposing NLRBs change in standards for determining joint employer status; Support the H.R. 2745, Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER Act), a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority; Urged that attention be payed to the anti-competitive effects and consumer harms in the Anthem / Cigna deal that result from the BCBS affiliation of Anthem.

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

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI; Support Appropriations measures related to funding of our health care priorities (eg. nurse education, rural health, hospital preparedness, etc).

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services to veterans under S. 759. Enhancing Veteran's Care Through the Veteran Care Agreements Act of 2015; Outlining hospitals views of the barriers, obstacles to EHR interoperability; Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement.

Supporting HJ Res 29 and SJ Res. 8 to nullify NLRBs expedited union elections rule; Opposing NLRBs change in standards for determining joint employer status; Support the H.R. 2745, Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER Act), a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority; Urged that attention be payed to the anti-competitive effects and consumer harms in the Anthem / Cigna deal that result from the BCBS affiliation of Anthem.

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

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program,that Stage 3 not begin until no sooner than 2019 and that meaningful use requirements for hospitals and CAHs align with those for eligible clinicians in MACRA; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records; Letter to CMS urging use of existing authority to bring flexibility to the EHR Incentive Program and discussion about needed flexibility; Support H.R. 5164, Rural Hospital Regulatory Relief Act, a bill to extend the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals; Support S. 3129/H.R. 5613, legislation to extend through CY2016, the enforcement moratorium on CMS direct supervision policy for CAHs and small, rural hospitals.

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI; Support Appropriations measures related to funding of our health care priorities (eg. nurse education, rural health, hospital preparedness, etc).

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services to veterans under S. 759. Enhancing Veteran's Care Through the Veteran Care Agreements Act of 2015; Outlining hospitals views of the barriers, obstacles to EHR interoperability; Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement.

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI.

Supporting HJ Res 29 and SJ Res. 8 to nullify NLRBs expedited union elections rule; Opposing NLRBs change in standards for determining joint employer status; Support the H.R. 2745, Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER Act), a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority;Testified at three Insurance Consolidation Hearings to discuss the impact of the proposed acquisitions involving Aetna/ Humana and Anthem/Cigna; Urged that attention be payed to the anti-competitive effects and consumer harms in the Anthem / Cigna deal that result from the BCBS affiliation of Anthem.

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

Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program and that Stage 3 not begin until 75 percent of EHs, CAHs and EPs attain Stage 2.; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support S 629 and H.R. 1784, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Urged limitations on Recovery Audit Contractors (RACs)that includes financial penalties for inaccurate audit decisions; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 976 and HR 2513 Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records.

Supporting clarification and further explanation in final regulations establishing 501(r) requirements for hospitals. Urging reconfiguration of Schedule H to include on the forms first page the value of hospitals contribution related to housing services as community benefit. Supporting preservation of tax exempt status for hospitals. Opposing requirement that hospitals provide to patients a detailed list of all the individual providers that are covered by the individual hospitals financial assistance policy to satisfy the obligation under 501(r) of the Code.

Supporting HJ Res 29 and SJ Res. 8 to nullify NLRBs expedited union elections rule; Opposing NLRBs change in standards for determining joint employer status.

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services to veterans under S. 759. Enhancing Veteran 5 Care Through Veteran Care Agreements Act of 2015. Outlining hospitals views of the barriers, obstacles to EHR interoperability. Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement.

HALO letter sent to Congress about the Medicare Sustainable Growth Rate (SGR) for physician payment; Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and to extend non-enforcement for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibility: advocating for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program and that Stage 3 not begin until 75 percent of EHs, CAHs and EPs attain Stage 2.; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support HR 2, Medicare Access and CHIP Reauthorization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Childrens Health Insurance Program; Support HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals; Support S 629, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Oppose Recovery Audit Contracts (RACs)Section 3 that imposes financial penalties on RACs; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 1295, Trade Preferences Extension Act of 2015because the inclusion of the Medicare sequestration offset; Oppose HR 976 and HR 2513Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process; Support S. 2141 Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act, a bill for improved transparency of information about certified EHRs; Advocate to improve interoperability of electronic health records.

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI.

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI.

Supporting clarification and further explanation in final regulations establishing 501(r) requirements for hospitals. Urging reconfiguration of Schedule H to include on the forms first page the value of hospitals contribution related to housing services as community benefit. Supporting preservation of tax exempt status for hospitals. Opposing requirement that hospitals provide to patients a detailed list of all the individual providers that are covered by the individual hospitals financial assistance policy to satisfy the obligation under 501(r) of the Code.

HALO letter sent to Congress about the Medicare Sustainable Growth Rate (SGR) for physician payment; Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which provide incentives and penalties to encourage meaningful use of EHRs by hospitals and physicians and to extend non-enforcement instruction for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibilityadvocate for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support HR 2, Medicare Access and CHIP Reauthorization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Childrens Health Insurance Program; Support HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals; Support S 629, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Oppose Recovery Audit Contracts (RACs)Section 3 that imposes financial penalties on RACs; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Discussions to oppose site neutral payments. Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 1295, Trade Preferences Extension Act of 2015because the inclusion of the Medicare sequestration offset; Oppose HR 976 and HR 2513Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program; Discuss S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 with the Senate Finance Committee to reform the Medicare audits and appeals process.

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services to veterans under S. 759. Enhancing Veteran 5 Care Through Veteran Care Agreements Act of 2015. Outlining hospitals views of the barriers, obstacles to EHR interoperability. Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement.

Supporting HJ Res 29 and SJ Res. 8 to nullify NLRBs expedited union elections rule; Opposing NLRBs change in standards for determining joint employer status.

Opposing OFFCPs exercise of federal subcontractor oversight and enforcement for hospitals receiving federal reimbursement for providing health care services; Outlining hospitals views of the barriers, obstacles to EHR interoperability; Supporting update of standards for antitrust examination of hospital mergers that includes assessment of future competitive benefits of the arrangement; Opposing OFCCPs exercise of regulatory and enforcement authority over health care providers providing services to veterans under S. 759 Enhancing Veteran 5 Care Through Veteran Care Agreements Act of 2015.

Support H.Con. Res. 27,S. Con. Res. 11, and H. Res. 163Concurrent resolution on the budget for fiscal year 2016, Establishing the budget for the United States Government for fiscal year 2016 and setting forth appropriate budgetary levels for fiscal years 2017 through 2025; Express concern to House Appropriations Committee regarding funding levels for AHRCQ and CMMI.

Supporting HJ Res 29 and SJ Res. 8 to nullify NLRBs expedited union elections rule; Opposing NLRBs change in standards for determining joint employer status.

HALO letter sent to Congress about the Medicare Sustainable Growth Rate (SGR) for physician payment; Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which provide incentives and penalties to encourage meaningful use of EHRs by hospitals and physicians and to extend non-enforcement instruction for the Medicare direct supervision requirement for therapeutic hospital outpatient services for CAHs and rural hospitals ; Meaningful use flexibilityadvocate for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support HR 2, Medicare Access and CHIP Reauthorization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Childrens Health Insurance Program; Support HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals; Support S 629, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Oppose Recovery Audit Contracts (RACs)Section 3 that imposes financial penalties on RACs; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Discussions to oppose site neutral payments. Provide input to CMS on implementation of quality measures required under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014; Analyze and develop suggested changes to the Personalize Your Care Act of 2015, a bill that would provide coverage of voluntary advance care planning consultation under Medicare and Medicaid; Oppose HR 2895, Medicare Patient Access to Cancer Treatment Act of 2015, a bill that would establish parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting; Oppose HR 1295, Trade Preferences Extension Act of 2015because the inclusion of the Medicare sequestration offset; Oppose HR 976 and HR 2513Promoting Access, Competition, and Equity Act of 2015(PACE) Act of 2015, a bill to allow an increase in, and expansion of, physician-owned hospitals eligible for Medicare reimbursement; Support S 1148 and HR 2124Resident Physician Shortage Reduction Act of 2015, a bill to increase the number of Medicare-supported physician residency slots; Urged SFC Chronic Care Working Group to consider expanding access to telehealth, removing legal barriers to clinical integration, and better engaging beneficiaries in their health and health care;Testified at the Observation status, Improving competition in Medicare and Prompt payment hearings; Support HR 2156, Medicare Audit Improvement Act of 2015, a bill to amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program, and for other purposes.

Supporting clarification and further explanation in final regulations establishing 501(r) requirements for hospitals; Urging reconfiguration of Schedule H to account for housing services as a community benefit; Urging simplification of the 501(r)-related requirement to list individually all providers subject to the hospitals financial assistance policy; We urged preservation of tax exempt status for hospitals.

HALO letter sent to Congress about the Medicare Sustainable Growth Rate (SGR) for physician payment; Support HR 672 and S 607, Rural Community Hospital (RCH) Demonstration Extension Act of 2015, a bill that will extend the demonstration for five more years, will ensure that RCH continues to help Americas communities in many ways, especially by allowing hospitals to expand and improve the services rural communities need. Also enables hospitals with fewer than 51 beds to test the feasibility of cost-based reimbursement. Affects 23 small, rural hospitals nationwide. Demo included in MMA, extended and expanded in ACA and Budget neutral; Support HR 663 and S 332, Rural Hospital Access Act of 2015, a bill that would make permanent both the Medicare-dependent Hospital (MDH) program and the enhanced low-volume Medicare adjustment for prospective payment system (PPS) hospitals, which are vital programs for rural hospitals and the patients and communities they serve; Support S 257 and HR 1611, Protecting Access to Rural Therapy Services (PARTs)Act of 2015, a bill that would provide hospitals relief from the Centers for Medicare & Medicaid Services (CMS) regulations with respect to direct supervision of outpatient therapeutic services; Support HR 270,Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bill that requires the Centers for Medicare & Medicaid Services (CMS) to make a necessary adjustment to how it implements the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which provide incentives and penalties to encourage meaningful use of EHRs by hospitals and physicians; Meaningful use flexibilityadvocate for a shorter meaningful use reporting period and other flexibilities that would increase hospitals ability to meet Stage 2 and move forward with the program; Support S. 377 and HR 745, Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, a bill to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program; Support S. 688 and HR 1343, Establishing Beneficiary Equity in the Hospital Readmission Program Act of 2015, a bill to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support HR 2, Medicare Access and CHIP Reauthorization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Childrens Health Insurance Program; Support HR 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, a bill to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and improve Medicare payments for physicians and other professionals; Support S 629, Making the Education of Nurses Dependable for Schools Act, a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Oppose Recovery Audit Contracts (RACs)Section 3 that imposes financial penalties on RACs -- top ask given contingency fees are a no go; Support ICD-10 delay and advocate to maintain the Oct. 1, 2015 transition date for ICD-10; Discussions to oppose site neutral payments.

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in MedicareTelehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, a bill that is an important step toward easing the shortage of psychiatric beds in communities across the nation and revise the length of the emergency psychiatric demonstration project that is currently limited to three years; Support H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with members of congress; Working with the Assistant Secretary for Preparedness and Response (ASPR) on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients; Discussion of the impact of FDA draft guidance on laboratory developed tests (LDTs); Discussion of draft guidance on drug compounding and repackaging.

Supporting clarification and further explanation in final regulations establishing 501(r) requirements for hospitals.

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for an additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments;AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered,and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to services furnished since January 1, 2001; S.1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions; requested that the increasing number of hospital compliance reviews performed by the Office of Inspector General (OIG) Office of Audit Services in which the OIG has extrapolated audit findings to estimate Medicare overpayments to the hospitals and the hospitals Medicare Administrative Contractors (MACs)have sought to recover the extrapolated overpayment amounts be halted without delay; Support HR 5481, The Flexibility in Health IT Reporting (Flex-It) Act, a bill to continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs. Senate briefing on legal barriers to providers' ability to manage risk, particularly with respect to Medicare ACO programs. Support HR 4656 and S2276, Caring for America's Heroes Act, a bill to improve access to mental health services under the TRICARE program; Funding for Ebola treatment and preparedness as part of the FY15 Omnibus Appropriations Act. Met to discuss the HHS calculator issue to ensure employers cannot offer health plans that exclude inpatient hospital care.

Support HR 803 Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act, a bill to reform and strengthen the workforce investment system of the Nation to put Americans back to work and make the United States more competitive in the 21st century. Support HR 3633 Protecting Health Care Providers from Increased Administrative Burdens Act, clarifies Office of Federal Contract Compliance Programs (OFCCP) within the Department of Labor jurisdiction over hospitals participating in TRICARE ;Support HR 1406 Working Families Flexibility Act of 2013, a bill to amend the Fair Labor Standards Act of 1938 to provide compensatory time for employees in the private sector; Support HR 2346 Secret Ballot Protection Act, a bill to amend the National Labor Relations Act to ensure the right of employees to a secret ballot election conducted by the National Labor Relations Board; Urging IRS for purposes of section 4980H of the code to treat "on-call" hours consistent with the treatment of "on-call" under the Federal Fair Labor Standards Act; discussion with FTC Commission about the importance of clinical integration in the changing health care delivery environment and how that the FTCs current merger/acquisition model is not compatible with the clinical integration delivery model.

Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements; Monitoring the hospitals concerns about the impact of FTCs strategy related to retrospective review of hospital mergers; Discussed how HIPAA protects privacy and security of health information within hospital and other covered entities and their business associates and whether FTC has a role in protecting health information that is not otherwise protected by HIPAA.

Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements; Monitoring the hospitals concerns about the impact of FTCs strategy related to retrospective review of hospital mergers; Discussed how HIPAA protects privacy and security of health information within hospital and other covered entities and their business associates and whether FTC has a role in protecting health information that is not otherwise protected by HIPAA.

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, 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; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961 Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins(R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

Opposing cuts to hospital payments in the Senate and House FY 2014 budget resolutions as savings to pay for replacement of sequester reductions. Monitoring develpoments related to HR 933 The Consolidated and Further Continuing Appropriations Act of 2013, a bill making appropriations for the Department of Defense, the Department of Veterans Affairs, and other departments and agencies for the fiscal year ending September 30, 2013.

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for an additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments;AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered,and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S 1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to services furnished since January 1, 2001; S.1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions; requested that the increasing number of hospital compliance reviews performed by the Office of Inspector General (OIG) Office of Audit Services in which the OIG has extrapolated audit findings to estimate Medicare overpayments to the hospitals and the hospitals Medicare Administrative Contractors (MACs)have sought to recover the extrapolated overpayment amounts be halted without delay; Support HR 5481, The Flexibility in Health IT Reporting (Flex-It) Act, a bill to continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs.

Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements; Monitoring the hospitals concerns about the impact of FTCs strategy related to retrospective review of hospital mergers.

Opposing cuts to hospital payments in the Senate and House FY 2014 budget resolutions as savings to pay for replacement of sequester reductions. Monitoring develpoments related to HR 933 The Consolidated and Further Continuing Appropriations Act of 2013, a bill making appropriations for the Department of Defense, the Department of Veterans Affairs, and other departments and agencies for the fiscal year ending September 30, 2013.

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, 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; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins (R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program foran additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments; AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered, and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S 1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to services furnished since January 1, 2001; S. 1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions; requested that the increasing number of hospital compliance reviews performed by the Office of Inspector General (OIG) Office of Audit Services in which the OIG has extrapolated audit findings to estimate Medicare overpayments to the hospitals and the hospitals Medicare Administrative Contractors (MACs) have sought to recover the extrapolated overpayment amounts be halted without delay.

Supporting the importance and continuation of the tax codes charitable contribution provisions for Americas nonprofit hospitals.

Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements; Monitoring the hospitals concerns about the impact of FTCs strategy related to retrospective review of hospital mergers.

Support HR 803 Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act, a bill to reform and strengthen the workforce investment system of the Nation to put Americans back to work and make the United States more competitive in the 21st century. Support HR 3633 Protecting Health Care Providers from Increased Administrative Burdens Act, clarifies Office of Federal Contract Compliance Programs (OFCCP) within the Department of Labor jurisdiction over hospitals participating in TRICARE ;Support HR 1406 Working Families Flexibility Act of 2013, a bill to amend the Fair Labor Standards Act of 1938 to provide compensatory time for employees in the private sector; Support HR 2346 Secret Ballot Protection Act, a bill to amend the National Labor Relations Act to ensure the right of employees to a secret ballot election conducted by the National Labor Relations Board; Urging IRS for purposes of section 4980H of the code to treat "on-call" hours consistent with the treatment of "on-call" under the Federal Fair Labor Statndards Act.

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program foran additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Requested the Health Resource and Service Admin (HRSA) to delay the compliance date by at least six months to allow sufficient time for affected hospitals to make the necessary modifications to their existing inventory management practices as required by the new GPO guidance and recommend that HRSA continue to work with affected 340B hospitals to provide guidance and education on the GPO compliance issues.; Discussion of the Medicaid ACA implementation --DSH, expansion, eligibility at CMS; Discussion of the implementation of the American Taxpayer Relief Act (ATRA) specifically, the outpatient therapy provision and extension of the MDH program and enhanced low-volume adjustment at CMS; Urged CMS to to extend the timeline for meaningful use in 2014 and provide greater flexibility in Stage 2; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments; AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered, and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Requested CMS to expedite its ICD-10 testing plans to ensure that testing begins no later than January 2014, be made available to all hospitals and include extensive end-to-end testing by Medicare contractors and state Medicaid agencies of both the electronic transaction and the adjudication of the claim; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S 1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to servicesfurnished since January 1, 2001; S. 1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions.

Opposing cuts to hospital payments in the Senate and House FY 2014 budget resolutions as savings to pay for replacement of sequester reductions. Monitoring develpoments related to HR 933 The Consolidated and Further Continuing Appropriations Act of 2013, a bill making appropriations for the Department of Defense, the Department of Veterans Affairs, and other departments and agencies for the fiscal year ending September 30, 2013.

Supporting extension of urging the quick release of fiscal rules to extend Stark/anti-kickback protections related to HIT donations from hospitals to physicians; Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements.

Supporting the importance and continuation of the tax codes charitable contribution provisions for Americas nonprofit hospitals.

Support HR 803 Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act, a bill to reform and strengthen the workforce investment system of the Nation to put Americans back to work and make the United States more competitive in the 21st century. Support HR 3633 Protecting Health Care Providers from Increased Administrative Burdens Act, clarifies Office of Federal Contract Compliance Programs (OFCCP) within the Department of Labor jurisdiction over hospitals participating in TRICARE ;Support HR 1406 Working Families Flexibility Act of 2013, a bill to amend the Fair Labor Standards Act of 1938 to provide compensatory time for employees in the private sector; Support HR 2346 Secret Ballot Protection Act, a bill to amend the National Labor Relations Act to ensure the right of employees to a secret ballot election conducted by the National Labor Relations Board; Urging IRS for purposes of section 4980H of the code to treat "on-call" hours consistent with the treatment of "on-call" under the Federal Fair Labor Statndards Act.

Opposing cuts to hospital payments in the Senate and House FY 2014 budget resolutions as savings to pay for replacement of sequester reductions. Monitoring develpoments related to HR 933 The Consolidated and Further Continuing Appropriations Act of 2013, a bill making appropriations for the Department of Defense, the Department of Veterans Affairs, and other departments and agencies for the fiscal year ending September 30, 2013.

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program foran additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Requested the Health Resource and Service Admin (HRSA) to delay the compliance date by at least six months to allow sufficient time for affected hospitals to make the necessary modifications to their existing inventory management practices as required by the new GPO guidance and recommend that HRSA continue to work with affected 340B hospitals to provide guidance and education on the GPO compliance issues.; Discussion of the Medicaid ACA implementation --DSH, expansion, eligibility at CMS; Discussion of the implementation of the American Taxpayer Relief Act (ATRA) specifically, the outpatient therapy provision and extension of the MDH program and enhanced low-volume adjustment at CMS; Urged CMS to allow the second option of reporting given that individual electronic health records (EHRs) or hospitals may not be ready to report inpatient quality reporting (IQR) measures electronically by a date certain of the implementation of the Medicare and Medicaid EHR Incentive Programs with CMS and the Office of the National Coordinator for Health Information Technology (ONC); Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments; AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered, and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Support HR 3717 Helping Families in Mental Health Crisis Act of 2013, the bill focuses programs and resources on psychiatric care for patients and families most in need of services; Support critical access hospital (CAH) 96 hours rule, physicians at (CAHs) must certify a condition of payment, at a hospital within 96 hours after admission to the CAH. Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Requested CMS to expedite its ICD-10 testing plans to ensure that testing begins no later than January 2014, be made available to all hospitals and include extensive end-to-end testing by Medicare contractors and state Medicaid agencies of both the electronic transaction and the adjudication of the claim.

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for anadditional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Requested the Health Resource and Service Admin (HRSA) to delay the compliance date by at least six months to allow sufficient time for affected hospitals to make the necessary modifications to their existing inventory management practices as required by the new GPO guidance and recommend that HRSA continue to work with affected 340B hospitals to provide guidance and education on the GPO compliance issues.; Discussion of the Medicaid ACA implementation --DSH, expansion, eligibility at CMS; Discussion of the implementation of the American Taxpayer Relief Act (ATRA) specifically, the outpatient therapy provision and extension of the MDH program and enhanced low-volume adjustment at CMS; Urged CMS to allow the second option of reporting given that individual electronic health records (EHRs) or hospitals may not be ready to report inpatient quality reporting (IQR) measures electronically by a date certain of the implementation of the Medicare and Medicaid EHR Incentive Programs with CMS and the Office of the National Coordinator for Health Information Technology (ONC); Opposing CMSs proposed rule on Part A to Part B rebilling as too limiting regarding what claims would qualify for rebilling; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments; AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered, and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals.

Opposing cuts to hospital payments in the Senate and House FY 2014 budget resolutions as savings to pay for replacement of sequester reductions. Monitoring develpoments related to HR 933 The Consolidated and Further Continuing Appropriations Act of 2013, a bill making appropriations for the Department of Defense, the Department of Veterans Affairs, and other departments and agencies for the fiscal year ending September 30, 2013.

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, 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; Support CMS proposed rule aimed at reducing burden and and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Support S 1143 and HR 2801 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Supporting the Health Care Price Transparency Promotion Act of 2013 to require States to have or establish requirements for disclosure of information on hospital charges for certain services and require insurers to provide enrollees with information on out-of-pocket expenditures upon request; Support 340B Drug Program; Support for Rep. Lynn Jenkins (R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system;

Supporting the importance and continuation of the tax codes charitable contribution provisions for Americas nonprofit hospitals.

Supporting the importance and continuation of the tax codes charitable contribution provisions for Americas nonprofit hospitals.

Supporting extension of the Stark/anti-kickback regulations related to HIT donations from hospitals to physicians; Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements.

Support HR 803 Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act, a bill to reform and strengthen the workforce investment system of the Nation to put Americans back to work and make the United States more competitive in the 21st century. Opposing Office of Federal Contract Compliance Programs (OFCCP) within the Department of Labor continued attempt to expand their jurisdiction over hospitals participating in TRICARE despite the NDAA exemption and the ARBs decision in Florida Hospital;Support HR 1406 Working Families Flexibility Act of 2013, a bill to amend the Fair Labor Standards Act of 1938 to provide compensatory time for employees in the private sector; Support HR 2346 Secret Ballot Protection Act, a bill to amend the National Labor Relations Act to ensure the right of employees to a secret ballot election conducted by the National Labor Relations Board.

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for anadditional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Requested the Health Resource and Service Admin (HRSA) to delay the compliance date by at least six months to allow sufficient time for affected hospitals to make the necessary modifications to their existing inventory management practices as required by the new GPO guidance and recommend that HRSA continue to work with affected 340B hospitals to provide guidance and education on the GPO compliance issues.; Discussion of the Medicaid ACA implementation --DSH, expansion, eligibility at CMS; Discussion of the implementation of the American Taxpayer Relief Act (ATRA) specifically, the outpatient therapy provision and extension of the MDH program and enhanced low-volume adjustment at CMS; Urged CMS to allow the second option of reporting given that individual electronic health records (EHRs) or hospitals may not be ready to report inpatient quality reporting (IQR) measures electronically by a date certain of the implementation of the Medicare and Medicaid EHR Incentive Programs with CMS and the Office of the National Coordinator for Health Information Technology (ONC); Opposing CMSs proposed rule on Part A to Part B rebilling as too limiting regarding what claims would qualify for rebilling; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments; AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered, and reduce unnecessary hospital expenditures.

Support HR 803 Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act, a bill to reform and strengthen the workforce investment system of the Nation to put Americans back to work and make the United States more competitive in the 21st century. Opposing Office of Federal Contract Compliance Programs (OFCCP) within the Department of Labor continued attempt to expand their jurisdiction over hospitals participating in TRICARE despite the NDAA exemption and the ARBs decision in Florida Hospital;Support HR 1406 Working Families Flexibility Act of 2013, a bill to amend the Fair Labor Standards Act of 1938 to provide compensatory time for employees in the private sector; Support HR 2346 Secret Ballot Protection Act, a bill to amend the National Labor Relations Act to ensure the right of employees to a secret ballot election conducted by the National Labor Relations Board.

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, 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; Support CMS proposed rule aimed at reducing burden and and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Support S 1143 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Supporting the Health Care Price Transparency Promotion Act of 2013 to require States to have or establish requirements for disclosure of information on hospital charges for certain services and require insurers to provide enrollees with information on out-of-pocket expenditures upon request.

Supporting the importance and continuation of the tax codes charitable contribution provisions for Americas nonprofit hospitals.

Opposing cuts to hospital payments in the Senate and House FY 2014 budget resolutions as savings to pay for replacement of sequester reductions. Monitoring develpoments related to HR 933 The Consolidated and Further Continuing Appropriations Act of 2013, a bill making appropriations for the Department of Defense, the Department of Veterans Affairs, and other departments and agencies for the fiscal year ending September 30, 2013.

Supporting extension of the Stark/anti-kickback regulations related to HIT donations from hospitals to physicians; Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements.

Support HR 803 Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act, a bill to reform and strengthen the workforce investment system of the Nation to put Americans back to work and make the United States more competitive in the 21st century. Opposing Office of Federal Contract Compliance Programs (OFCCP) within the Department of Labor continued attempt to expand their jurisdiction over hospitals participating in TRICARE despite the NDAA exemption and the ARBs decision in Florida Hospital;

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, 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; Support CMS proposed rule aimed at reducing burden and and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation;

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for anadditional five years through fiscal year (FY) 2017; Support HR 1250 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Requested the Health Resource and Service Admin (HRSA) to delay the compliance date by at least six months to allow sufficient time for affected hospitals to make the necessary modifications to their existing inventory management practices as required by the new GPO guidance and recommend that HRSA continue to work with affected 340B hospitals to provide guidance and education on the GPO compliance issues.; Discussion of the Medicaid ACA implementation --DSH, expansion, eligibility at CMS; Discussion of the implementation of the American Taxpayer Relief Act (ATRA) specifically, the outpatient therapy provision and extension of the MDH program and enhanced low-volume adjustment at CMS; Urged CMS to allow the second option of reporting given that individual electronic health records (EHRs) or hospitals may not be ready to report inpatient quality reporting (IQR) measures electronically by a date certain of the implementation of the Medicare and Medicaid EHR Incentive Programs with CMS and the Office of the National Coordinator for Health Information Technology (ONC); Opposing CMSs proposed rule on Part A to Part B rebilling as too limiting regarding what claims would qualify for rebilling.

S 217, HR 972 Supporting the Secret Ballot Protection Act, makes it an unfair labor practice under the NLRA for an employer to recognize a union that has not been selected via secret ballot and unlawful for a union that has not been chosen as the employees' exclusive representative in a secret ballot election conducted by the NLRB to cause or attempt to cause an employer to recognize or bargain with it; HR 2573 and S 1431 Rural Health Care Capital Access Reauthorization Act of 2011, supporting a bill to amend section 242 of the National Housing Act to extend the sunset provisions for the exemption for critical access hospitals under the FHA programs of mortgage insurance for hospitals; Expressing concerns about OFCCPs interpretation that the recently enacted TRICARE exemption in the Defense Authorization Act (S. 1253) has no effect on whether hospitals participating in TRICARE are federal subcontracts and subject to OFCCP regulatory requirements and oversight; Urging EEOC to ensure that any new agency guidance on use of criminal background checks does not restrict hospitals ability to appropriately use them in hiring, employment, credentialing, etc., especially for employees who have direct patient care responsibilities; S 2168 Re-empowerment of Skilled and Professional Employees and Construction Tradesworkers Act RESPECT Act, Opposed this bill to amend the National Labor Relations Act to modify the definition of supervisor; S J. Resolution 36 provides for congressional disapproval and nullification of the National Labor Relations Boards rule that substantially changes procedures for union representation elections; AHA expresses concerns that OFCCP continues to extend their jurisdiction to hospitals that treat, for example, patients covered by FEHBP or other federal health care programs, including Medicare Parts C and D especially because hospitals are pulled in as unknowing subcontractors.

Elimination of Legal/regulatory barriers to clinical integration: antitrust, Stark, anti-kickback, and CMPs; S 890 Fighting Fraud to Protect Taxpayers Act of 2011, seeking to enact double recovery of damages by expanding the type of costs to be recovered by the government to include investigative, legal, and other costs related to litigation; Meeting with members of House Judiciary Committee to propose legislation to amend the False Claims Act by requiring federal agencies to review their own rules and regulations to determine whether a billing dispute should be pursued as fraud before launching an investigation, and assure that unintentional billing disputes arent penalized as harshly as fraud.

HR 1, HJ Res 44, and HJRes 48 Budget, additional 2011 Appropriations Amendments; HR1255 Government Shutdown Prevention Act of 2011, to prevent a shutdown of the government of the United States; Maintain funding the Childrens Hospitals Graduate Medical Education program; H. Con. Res. 34 Ryan Budget, establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal year 2013 through 2021; HR 2017, H. J. Res. 79, H. J. Res. 94, H. J. Res. 95 bills for the Appropriations Continuing Resolution; HR 2055 Consolidated Appropriations Act 2012; OMB Document Federal Budget For FY 2013 Total Medicare Provider cuts: $267.923 B from FY 13 22 Total Medicaid cuts: $51.561 B /10 years; FY 2013 Labor FY 2013 HHS Budget, urged congressional appropriators to give funding priority in fiscal year 2013 to discretionary health care programs shown to improve access to quality health care; these include programs funding Childrens Hospitals Graduate Medical Education, health professions education and workforce challenges, rural health, hospital preparedness, health care quality and safety, and other public health and health care needs; A letter to HUD objecting to a notice announcing an increase of between 30 percent and 40 percent for premiums hospitals would have to pay to get mortgage insurance under the Hospital Mortgage Insurance program (the 242 program) in 2013.

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, 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; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 and HR 2245 Preserving Access to Life-Saving Medications Act of 2011, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 to repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program; HR 1214 a bill to repeal mandatory funding for school-based health center construction, it amends the Patient Protection and Affordable Care Act to repeal the program requiring the Secretary of Health and Human Services (HHS) to award grants to school-based health centers or their sponsoring facilities to support the operation of such health centers. Rescinds unobligated appropriations for the program. Urging that final Accounting of Disclosures rule not include the proposal to require provision of an access report to patients; HR 1540 National Defense Authorization Act of 2012, a bill to establish a working group within the Department of Defense to comprehensively review all TRICARE policies and practices related to pediatric care and to develop recommendations that specifically address the health care needs of children of military families; S 1854 Medical Surge Capacity Act, a bill to enhance medical surge capacity which uses lessons learned from previous disasters to make critical changes when responding to a natural or manmade disaster; HR 2405 and S 1855 Pandemic and All-Hazards Preparedness Act Reauthorization of 2011, a bill to amend the Public Health Service Act to reauthorize various programs under the Pandemic and All-Hazards Preparedness Act; S. 1979 Conrad State 30 Improvement Act (Immigration) , a bill to help streamline J-1 visa waiver process for hospitals to hire international physicians to practice in rural and medically underserved communities; Critical Access Hospital (CAH) Letter from Rep. Ron Kind and Rep. Jo Ann Emerson to the supercommittee to protect CAH from potential cuts or other detrimental policy changes; Urging the Super Committee to reject cuts to inpatient rehabilitation facilities (IRFs); Extender's letter to supercommittee with a list of hospital specific issues that need to be addressed; HR 3586 Good Samaratin Health Professionals Act, a bill to amend the PHSA to limit the liability of healthcare professionals who volunteer to provide healthcare services in response to disaster; HR 3839 Drug Shortage Prevention Act of 2012, to address critical drug shortage; S 2193 Ensuring Safe Medical Devices for Patients, a bill to require the Food and Drug Administration to include devices in the postmarket risk identification and analysis system, to expedite the implementation of the unique device identification system for medical devices; HR 4246 VA Enrollment Act, to amend title 38, United States Code, to provide for the expansion of eligibility for veteran reimbursement for emergency treatment provided in non-Department of Veterans Affairs facilities; HR 5800 Health Care Price Transparency Promotion Act of 2012, 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; H.R.6118 and S.3391 Taking Essential Steps for Testing Act of 2012. to amend the Public Health Service Act to revise sanctions for laboratories that intentionally refer proficiency testing samples required for certification to another laboratory for analysis by: (1) giving the Secretary of Health and Human Services (HHS) discretion to substitute intermediate sanctions for such violations instead of the two-year prohibition against ownership or operation which would otherwise apply, and (2) making the one-year certificate revocation for such a laboratory optional rather than mandatory. Which gives CMS more discretion in enforcing the Clinical Laboratory Improvement Amendments to preserve patient access to lab services.

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, 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; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 and HR 2245 Preserving Access to Life-Saving Medications Act of 2011, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 to repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program; HR 1214 a bill to repeal mandatory funding for school-based health center construction, it amends the Patient Protection and Affordable Care Act to repeal the program requiring the Secretary of Health and Human Services (HHS) to award grants to school-based health centers or their sponsoring facilities to support the operation of such health centers. Rescinds unobligated appropriations for the program. Urging that final Accounting of Disclosures rule not include the proposal to require provision of an access report to patients; HR 1540 National Defense Authorization Act of 2012, a bill to establish a working group within the Department of Defense to comprehensively review all TRICARE policies and practices related to pediatric care and to develop recommendations that specifically address the health care needs of children of military families; S 1854 Medical Surge Capacity Act, a bill to enhance medical surge capacity which uses lessons learned from previous disasters to make critical changes when responding to a natural or manmade disaster; HR 2405 and S 1855 Pandemic and All-Hazards Preparedness Act Reauthorization of 2011, a bill to amend the Public Health Service Act to reauthorize various programs under the Pandemic and All-Hazards Preparedness Act; S. 1979 Conrad State 30 Improvement Act (Immigration) , a bill to help streamline J-1 visa waiver process for hospitals to hire international physicians to practice in rural and medically underserved communities; Critical Access Hospital (CAH) Letter from Rep. Ron Kind and Rep. Jo Ann Emerson to the supercommittee to protect CAH from potential cuts or other detrimental policy changes; Urging the Super Committee to reject cuts to inpatient rehabilitation facilities (IRFs); Extender's letter to supercommittee with a list of hospital specific issues that need to be addressed; HR 3586 Good Samaratin Health Professionals Act, a bill to amend the PHSA to limit the liability of healthcare professionals who volunteer to provide healthcare services in response to disaster; HR 3839 Drug Shortage Prevention Act of 2012, to address critical drug shortage; S 2193 Ensuring Safe Medical Devices for Patients, a bill to require the Food and Drug Administration to include devices in the postmarket risk identification and analysis system, to expedite the implementation of the unique device identification system for medical devices; HR 4246 VA Enrollment Act, to amend title 38, United States Code, to provide for the expansion of eligibility for veteran reimbursement for emergency treatment provided in non-Department of Veterans Affairs facilities; HR 5800 Health Care Price Transparency Promotion Act of 2012, 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; H.R.6118 and S.3391 Taking Essential Steps for Testing Act of 2012. to amend the Public Health Service Act to revise sanctions for laboratories that intentionally refer proficiency testing samples required for certification to another laboratory for analysis by: (1) giving the Secretary of Health and Human Services (HHS) discretion to substitute intermediate sanctions for such violations instead of the two-year prohibition against ownership or operation which would otherwise apply, and (2) making the one-year certificate revocation for such a laboratory optional rather than mandatory. Which gives CMS more discretion in enforcing the Clinical Laboratory Improvement Amendments to preserve patient access to lab services.

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 and HR 2783 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; HR 1398 Rural Hospital Protection Act, legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; S 1486 Long-Term Care Hospital Improvement Act of 201, a bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program; Raising concerns about CMS flawed methodology that overstates the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expired in September 2011, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; S 1251Medicare and Medicaid FAST Act, a bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs; HR 2500 Equal Access and Parity for Multi-Campus Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 2674 340B Program Improvement Act, a bill to amend section 340B of the Public Health Service Act to improve the provision of discounts on drug purchases for certain safety net providers; HR 3630 Temporary Payroll Tax Cut Continuation Act of 2011 or Middle Class Tax Relief and Job Creation Act of 2011, a bill that cuts hospitals to pay for the doc fix, it contains the Social Security payroll tax cut and the Unemployment Insurance extension; HR 3519 a bill to amend and exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; S. 1680 Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2011, a bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; Letter to Rehberg and DeLauro in support of the CHGME program that was circulated by Reps. Capps and Bilbray; Wyden/Crapo letter to CMS to actively oppose a Senate Dear Colleague letter to CMS in support of updating Medicare payments to ambulatory surgery centers (ASCs). The letter did not request a payment update for ASCs. Rather, the letter advocated against the Medicare payment rate for services provided in hospital outpatient department settings; HR 2954 and S 2474 Health Equity and Accountability Act of 2011, Comprehensive bill focused on eliminating racial and ethnic disparities in health care through improved data collection and reporting, culturally and linguistically-appropriate health care, workforce diversity, health information technology, and other actions; Discussions with the Administration (CMS) on applying the therapy cap to hospital outpatient departments; Worked to change CMS definition of allowed EHR costs for CAH Meaningful Use incentive payments to include capital lease purchases of EHRs; HR 3859 Rural Hospital and Provider Equity (R-HOPE) Act of 2012, to amend title XVIII of the SSA to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; HR 4245 Veterans Co-Pay Fairness Act, to amend title 38, United States Code, to require the Secretary of Veterans Affairs to reimburse eligible veterans who are entitled to Medicare benefits for Medicare deductibles and other expenses that are owed by the veterans for emergency medical treatment provided in non-Department of Veterans affairs facilities; S 2620 and HR 5943 Rural Hospital Access Act of 2012, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; S 3187 and HR 5651Prescription Drug User Fee Amendments of 2012, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs and medical devices, to establish user-fee programs for generic drugs and biosimilars.

HR 1, HJ Res 44, and HJRes 48 Budget, additional 2011 Appropriations Amendments; HR1255 Government Shutdown Prevention Act of 2011, to prevent a shutdown of the government of the United States; Maintain funding the Childrens Hospitals Graduate Medical Education program; H. Con. Res. 34 Ryan Budget, establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal year 2013 through 2021; HR 2017, H. J. Res. 79, H. J. Res. 94, H. J. Res. 95 bills for the Appropriations Continuing Resolution; HR 2055 Consolidated Appropriations Act 2012; OMB Document Federal Budget For FY 2013 Total Medicare Provider cuts: $267.923 B from FY 13 22 Total Medicaid cuts: $51.561 B /10 years; FY 2013 Labor FY 2013 HHS Budget, urged congressional appropriators to give funding priority in fiscal year 2013 to discretionary health care programs shown to improve access to quality health care; these include programs funding Childrens Hospitals Graduate Medical Education, health professions education and workforce challenges, rural health, hospital preparedness, health care quality and safety, and other public health and health care needs; A letter to HUD objecting to a notice announcing an increase of between 30 percent and 40 percent for premiums hospitals would have to pay to get mortgage insurance under the Hospital Mortgage Insurance program (the 242 program) in 2013.

Elimination of Legal/regulatory barriers to clinical integration: antitrust, Stark, anti-kickback, and CMPs; S 890 Fighting Fraud to Protect Taxpayers Act of 2011, seeking to enact double recovery of damages by expanding the type of costs to be recovered by the government to include investigative, legal, and other costs related to litigation; Meeting with members of House Judiciary Committee to propose legislation to amend the False Claims Act by requiring federal agencies to review their own rules and regulations to determine whether a billing dispute should be pursued as fraud before launching an investigation, and assure that unintentional billing disputes arent penalized as harshly as fraud.

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 and HR 2783 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; HR 1398 Rural Hospital Protection Act, legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; S 1486 Long-Term Care Hospital Improvement Act of 201, a bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program; Raising concerns about CMS flawed methodology that overstates the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expired in September 2011, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; S 1251Medicare and Medicaid FAST Act, a bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs; HR 2500 Equal Access and Parity for Multi-Campus Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 2674 340B Program Improvement Act, a bill to amend section 340B of the Public Health Service Act to improve the provision of discounts on drug purchases for certain safety net providers; HR 3630 Temporary Payroll Tax Cut Continuation Act of 2011 or Middle Class Tax Relief and Job Creation Act of 2011, a bill that cuts hospitals to pay for the doc fix, it contains the Social Security payroll tax cut and the Unemployment Insurance extension; HR 3519 a bill to amend and exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; S. 1680 Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2011, a bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; Letter to Rehberg and DeLauro in support of the CHGME program that was circulated by Reps. Capps and Bilbray; Wyden/Crapo letter to CMS to actively oppose a Senate Dear Colleague letter to CMS in support of updating Medicare payments to ambulatory surgery centers (ASCs). The letter did not request a payment update for ASCs. Rather, the letter advocated against the Medicare payment rate for services provided in hospital outpatient department settings; HR 2954 Health Equity and Accountability Act of 2011, Comprehensive bill focused on eliminating racial and ethnic disparities in health care through improved data collection and reporting, culturally and linguistically-appropriate health care, workforce diversity, health information technology, and other actions; Discussions with the Administration (CMS) on applying the therapy cap to hospital outpatient departments; Worked to change CMS definition of allowed EHR costs for CAH Meaningful Use incentive payments to include capital lease purchases of EHRs; HR 3859 Rural Hospital and Provider Equity (R-HOPE) Act of 2012, to amend title XVIII of the SSA to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program. HR 4245 Veterans Co-Pay Fairness Act, to amend title 38, United States Code, to require the Secretary of Veterans Affairs to reimburse eligible veterans who are entitled to Medicare benefits for Medicare deductibles and other expenses that are owed by the veterans for emergency medical treatment provided in non-Department of Veterans Affairs facilities; S 2620 and HR 5943 Rural Hospital Access Act of 2012, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; S 3187 and HR 5651Prescription Drug User Fee Amendments of 2012, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs and medical devices, to establish user-fee programs for generic drugs and biosimilars.

HR 1, HJ Res 44, and HJRes 48 Budget, additional 2011 Appropriations Amendments; HR1255 Government Shutdown Prevention Act of 2011, to prevent a shutdown of the government of the United States; Maintain funding the Childrens Hospitals Graduate Medical Education program; H. Con. Res. 34 Ryan Budget, establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal year 2013 through 2021; HR 2017, H. J. Res. 79, H. J. Res. 94, H. J. Res. 95 bills for the Appropriations Continuing Resolution; HR 2055 Consolidated Appropriations Act 2012; OMB Document Federal Budget For FY 2013 Total Medicare Provider cuts: $267.923 B from FY 13 22 Total Medicaid cuts: $51.561 B /10 years; FY 2013 Labor FY 2013 HHS Budget, urged congressional appropriators to give funding priority in fiscal year 2013 to discretionary health care programs shown to improve access to quality health care; these include programs funding Childrens Hospitals Graduate Medical Education, health professions education and workforce challenges, rural health, hospital preparedness, health care quality and safety, and other public health and health care needs; A letter to HUD objecting to a notice announcing an increase of between 30 percent and 40 percent for premiums hospitals would have to pay to get mortgage insurance under the Hospital Mortgage Insurance program (the 242 program) in 2013.

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, 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; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 and HR 2245 Preserving Access to Life-Saving Medications Act of 2011, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 to repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program; HR 1214 a bill to repeal mandatory funding for school-based health center construction, it amends the Patient Protection and Affordable Care Act to repeal the program requiring the Secretary of Health and Human Services (HHS) to award grants to school-based health centers or their sponsoring facilities to support the operation of such health centers. Rescinds unobligated appropriations for the program. Urging that final Accounting of Disclosures rule not include the proposal to require provision of an access report to patients; HR 1540 National Defense Authorization Act of 2012, a bill to establish a working group within the Department of Defense to comprehensively review all TRICARE policies and practices related to pediatric care and to develop recommendations that specifically address the health care needs of children of military families; S 1854 Medical Surge Capacity Act, a bill to enhance medical surge capacity which uses lessons learned from previous disasters to make critical changes when responding to a natural or manmade disaster; HR 2405 and S 1855 Pandemic and All-Hazards Preparedness Act Reauthorization of 2011, a bill to amend the Public Health Service Act to reauthorize various programs under the Pandemic and All-Hazards Preparedness Act; S. 1979 Conrad State 30 Improvement Act (Immigration) , a bill to help streamline J-1 visa waiver process for hospitals to hire international physicians to practice in rural and medically underserved communities; Critical Access Hospital (CAH) Letter from Rep. Ron Kind and Rep. Jo Ann Emerson to the supercommittee to protect CAH from potential cuts or other detrimental policy changes; Urging the Super Committee to reject cuts to inpatient rehabilitation facilities (IRFs); Extender's letter to supercommittee with a list of hospital specific issues that need to be addressed; HR 3586 Good Samaratin Health Professionals Act, a bill to amend the PHSA to limit the liability of healthcare professionals who volunteer to provide healthcare services in response to disaster; HR 3839 Drug Shortage Prevention Act of 2012, to address critical drug shortage; S 2193 Ensuring Safe Medical Devices for Patients, a bill to require the Food and Drug Administration to include devices in the postmarket risk identification and analysis system, to expedite the implementation of the unique device identification system for medical devices; HR 4246 VA Enrollment Act, to amend title 38, United States Code, to provide for the expansion of eligibility for veteran reimbursement for emergency treatment provided in non-Department of Veterans Affairs facilities; HR 5800 Health Care Price Transparency Promotion Act of 2012, 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.

S 217, HR 972 Supporting the Secret Ballot Protection Act, makes it an unfair labor practice under the NLRA for an employer to recognize a union that has not been selected via secret ballot and unlawful for a union that has not been chosen as the employees' exclusive representative in a secret ballot election conducted by the NLRB to cause or attempt to cause an employer to recognize or bargain with it; HR 2573 and S 1431 Rural Health Care Capital Access Reauthorization Act of 2011, supporting a bill to amend section 242 of the National Housing Act to extend the sunset provisions for the exemption for critical access hospitals under the FHA programs of mortgage insurance for hospitals; Expressing concerns about OFCCPs interpretation that the recently enacted TRICARE exemption in the Defense Authorization Act (S. 1253) has no effect on whether hospitals participating in TRICARE are federal subcontracts and subject to OFCCP regulatory requirements and oversight; Urging EEOC to ensure that any new agency guidance on use of criminal background checks does not restrict hospitals ability to appropriately use them in hiring, employment, credentialing, etc., especially for employees who have direct patient care responsibilities; S 2168 Re-empowerment of Skilled and Professional Employees and Construction Tradesworkers Act RESPECT Act, Opposed this bill to amend the National Labor Relations Act to modify the definition of supervisor; S J. Resolution 36 provides for congressional disapproval and nullification of the National Labor Relations Boards rule that substantially changes procedures for union representation elections; AHA express concerns that OFCCP continues to extend their jurisdiction to hospitals that treat, for example, patients covered by FEHBP or other federal health care programs, including Medicare Parts C and D especially because hospitals are pulled in as unknowing subcontractors.

Working to improve the schedule H reporting requirements for tax exempt hospitals including improving community benefit reporting as required by the Patient Protection and Affordable Care Act.

S 217, HR 972 Supporting the Secret Ballot Protection Act, makes it an unfair labor practice under the NLRA for an employer to recognize a union that has not been selected via secret ballot and unlawful for a union that has not been chosen as the employees' exclusive representative in a secret ballot election conducted by the NLRB to cause or attempt to cause an employer to recognize or bargain with it; HR 2573 and S 1431 Rural Health Care Capital Access Reauthorization Act of 2011, supporting a bill to amend section 242 of the National Housing Act to extend the sunset provisions for the exemption for critical access hospitals under the FHA programs of mortgage insurance for hospitals; Expressing concerns about OFCCPs interpretation that the recently enacted TRICARE exemption in the Defense Authorization Act (S. 1253) has no effect on whether hospitals participating in TRICARE are federal subcontracts and subject to OFCCP regulatory requirements and oversight; Urging EEOC to ensure that any new agency guidance on use of criminal background checks does not restrict hospitals ability to appropriately use them in hiring, employment, credentialing, etc., especially for employees who have direct patient care responsibilities; S 2168 Re-empowerment of Skilled and Professional Employees and Construction Tradesworkers Act RESPECT Act, Opposed this bill to amend the National Labor Relations Act to modify the definition of supervisor.

HR 1, HJ Res 44, and HJRes 48 Budget, additional 2011 Appropriations Amendments; HR1255 Government Shutdown Prevention Act of 2011, to prevent a shutdown of the government of the United States; Maintain funding the Childrens Hospitals Graduate Medical Education program; H. Con. Res. 34 Ryan Budget, establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal year 2013 through 2021; HR 2017, H. J. Res. 79, H. J. Res. 94, H. J. Res. 95 bills for the Appropriations Continuing Resolution; HR 2055 Consolidated Appropriations Act 2012; OMB Document Federal Budget For FY 2013 Total Medicare Provider cuts: $267.923 B from FY 13 22 Total Medicaid cuts: $51.561 B /10 years

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, 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; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 and HR 2245 Preserving Access to Life-Saving Medications Act of 2011, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 to repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program; HR 1214 a bill to repeal mandatory funding for school-based health center construction, it amends the Patient Protection and Affordable Care Act to repeal the program requiring the Secretary of Health and Human Services (HHS) to award grants to school-based health centers or their sponsoring facilities to support the operation of such health centers. Rescinds unobligated appropriations for the program. Urging that final Accounting of Disclosures rule not include the proposal to require provision of an access report to patients; HR 1540 National Defense Authorization Act of 2012, a bill to establish a working group within the Department of Defense to comprehensively review all TRICARE policies and practices related to pediatric care and to develop recommendations that specifically address the health care needs of children of military families; S 1854 Medical Surge Capacity Act, a bill to enhance medical surge capacity which uses lessons learned from previous disasters to make critical changes when responding to a natural or manmade disaster; HR 2405 and S 1855 Pandemic and All-Hazards Preparedness Act Reauthorization of 2011, a bill to amend the Public Health Service Act to reauthorize various programs under the Pandemic and All-Hazards Preparedness Act; S. 1979 Conrad State 30 Improvement Act (Immigration) , a bill to help streamline J-1 visa waiver process for hospitals to hire international physicians to practice in rural and medically underserved communities; Critical Access Hospital (CAH) Letter from Rep. Ron Kind and Rep. Jo Ann Emerson to the supercommittee to protect CAH from potential cuts or other detrimental policy changes; Urging the Super Committee to reject cuts to inpatient rehabilitation facilities (IRFs); Extender's letter to supercommittee with a list of hospital specific issues that need to be addressed; HR 3586 Good Samaratin Health Professionals Act, a bill to amend the PHSA to limit the liability of healthcare professionals who volunteer to provide healthcare services in response to disaster; HR 3839 Drug Shortage Prevention Act of 2012, to address critical drug shortage.

Elimination of Legal/regulatory barriers to clinical integration, antitrust, Stark, anti-kickback, and CMPs. S 890 Fighting Fraud to Protect Taxpayers Act of 2011, this bill seeks to enact double recovery of damages by expanding the type of costs to be recovered by the government to include investigative, legal, and other costs related to litigation.

HR 1, HJ Res 44, and HJRes 48 Budget, additional 2011 Appropriations Amendments; HR1255 Government Shutdown Prevention Act of 2011, to prevent a shutdown of the government of the United States; Maintain funding the Childrens Hospitals Graduate Medical Education program.H. Con. Res. 34 Ryan Budget, establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal year 2013 through 2021 HR 2017, H. J. Res. 79, H. J. Res. 94, H. J. Res. 95 bills for the Appropriations Continuing Resolution; HR 2055 Consolidated Appropriations Act 2012

S 217, HR 972 The Secret Ballot Protection Act, makes it an unfair labor practice under the NLRA for an employer to recognize a union that has not been selected via secret ballot and unlawful for a union that has not been chosen as the employees' exclusive representative in a secret ballot election conducted by the NLRB to cause or attempt to cause an employer to recognize or bargain with it; Urged Rep. Ruppersberger office to request of OFCCP further information about the expanded jurisdiction claimed by the Office over hospitals that participate as in-network providers in TRICARE, FEHBP as federal subcontractors; S. 1253 National Defense Authorization Act for Fiscal Year 2012 Supporting provision establishing exemption for TRICARE providers from designation as federal contractors subject to OFCCPs regulations and oversight; encouraging that final bill include this exemption.; HR 2573 and S 1431 Rural Health Care Capital Access Reauthorization Act of 2011, a bill to amend section 242 of the National Housing Act to extend the sunset provisions for the exemption for critical access hospitals under the FHA programs of mortgage insurance for hospitals.

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, 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; Reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA) P.L. 109-417, Emergency Preparedness; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 and HR 2245 Preserving Access to Life-Saving Medications Act of 2011, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 to repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program; HR 1214 a bill to repeal mandatory funding for school-based health center construction, it amends the Patient Protection and Affordable Care Act to repeal the program requiring the Secretary of Health and Human Services (HHS) to award grants to school-based health centers or their sponsoring facilities to support the operation of such health centers. Rescinds unobligated appropriations for the program. Urging that final Accounting of Disclosures rule not include the proposal to require provision of an access report to patients; S 365 and S 627 Budget Control Act of 2011, Established by Joint Select Comm on Deficit Reduction; HR 1540 National Defense Authorization Act of 2012, a bill to establish a working group within the Department of Defense to comprehensively review all TRICARE policies and practices related to pediatric care and to develop recommendations that specifically address the health care needs of children of military families; S 1854 Medical Surge Capacity Act, a bill to enhance medical surge capacity which uses lessons learned from previous disasters to make critical changes when responding to a natural or manmade disaster; S 1855 Pandemic and All-Hazards Preparedness Act Reauthorization of 2011, a bill to amend the Public Health Service Act to reauthorize various programs under the Pandemic and All-Hazards Preparedness Act; S. 1979 Conrad State 30 Improvement Act (Immigration) , a bill to help streamline J-1 visa waiver process for hospitals to hire international physicians to practice in rural and medically underserved communities; Critical Access Hospital (CAH) Letter from Rep. Ron Kind and Rep. Jo Ann Emerson to the supercommittee to protect CAH from potential cuts or other detrimental policy changes; Joint letter signed by the AHA, FAH, and AMRPA urging the Super Committee to reject cuts to inpatient rehabilitation facilities (IRFs); Extender's letter to supercommittee with a list of hospital specific issues that need to be addressed.

HR 1, HJ Res 44, and HJRes 48 Budget, additional 2011 Appropriations Amendments; HR1255 Government Shutdown Prevention Act of 2011, to prevent a shutdown of the government of the United States; Maintain funding the Childrens Hospitals Graduate Medical Education program.H. Con. Res. 34 Ryan Budget, establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal year 2013 through 2021

Working to improve the schedule H reporting requirements for tax exempt hospitals including improving community benefit reporting as required by the Patient Protection and Affordable Care Act.

Elimination of Legal/regulatory barriers to clinical integration, antitrust, Stark, anti-kickback, and CMPs. S 890 Fighting Fraud to Protect Taxpayers Act of 2011, this bill seeks to enact double recovery of damages by expanding the type of costs to be recovered by the government to include investigative, legal, and other costs related to litigation.

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 and HR 2783 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; HR 1398 Rural Hospital Protection Act, legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; S 1486 Long-Term Care Hospital Improvement Act of 201, a bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program; Raising concerns about CMS flawed methodology that overstate the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; Sessions Crowley and Stabenow-Murkowski IPPS letter requesting fixes to the coding offset circulated for signature; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expires in September, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; S 1251Medicare and Medicaid FAST Act, a bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs; HR 2500 Equal Access and Parity for Multi-Campus Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 2674 340B Program Improvement Act, a bill to amend section 340B of the Public Health Service Act to improve the provision of discounts on drug purchases for certain safety net providers.

S 217, HR 972 The Secret Ballot Protection Act, makes it an unfair labor practice under the NLRA for an employer to recognize a union that has not been selected via secret ballot and unlawful for a union that has not been chosen as the employees' exclusive representative in a secret ballot election conducted by the NLRB to cause or attempt to cause an employer to recognize or bargain with it; Urged Rep. Ruppersberger office to request of OFCCP further information about the expanded jurisdiction claimed by the Office over hospitals that participate as in-network providers in TRICARE, FEHBP as federal subcontractors; S. 1253 National Defense Authorization Act for Fiscal Year 2012 Supporting provision establishing exemption for TRICARE providers from designation as federal contractors subject to OFCCPs regulations and oversight; encouraging that final bill include this exemption.; HR 2573 and S 1431 Rural Health Care Capital Access Reauthorization Act of 2011, a bill to amend section 242 of the National Housing Act to extend the sunset provisions for the exemption for critical access hospitals under the FHA programs of mortgage insurance for hospitals.

HR 1 Full Year Continuing Appropriations Act 2011, making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011; HR 2 Repealing the Job-Killing Health Care Law Act, to repeal the job-killing health care law and health care-related provisions in the Health Care and Education Reconciliation Act of 2010; HR 4 Small Business Paperwork Mandate Elimination Act of 2011, offsets the cost of 1099 repeal by increasing the maximum amount of tax subsidy to be repaid if a persons (or familys) income exceeds 400% of poverty; HR 5, S 218, HR 105 and S 1099 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, 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; Reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA) P.L. 109-417, Emergency Preparedness; HRes 9 Instructing four committees to produce legislation to replace the health reform law and to include a permanent fix to the SGR; S 296 Preserving Access to Life-Saving Medications Act, to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages; HR 705 The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, to amend the Internal Revenue Code of 1986 to repeal the expansion of information reporting requirements to payments made to corporations, payments for property and other gross proceeds, and rental property expense payments; HR 1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges; HR 1217 To repeal the Prevention and Public Health Fund; S 539 Behavioral Health Information Technology Act of 2011, a bill to amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities; S 668 Health Care Bureaucrats Elimination Act, a bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the Independent Payment Advisory Board; Allow hospitals to claim the full cost of provider taxes as allowable costs; Ensure CAHs are paid at least 101 percent of costs by Medicare Advantage plans; Ensure that the Centers for Medicare & Medicaid Services (CMS) appropriately addresses the issue of direct supervision for outpatient therapeutic services for rural hospitals and CAHs; Ensure rural hospitals and CAHs have adequate reimbursement for certified registered nurse anesthetist and stand-by services; Exempt CAHs from the Independent Payment Advisory Board; Extend expiring provisions; Provide small, rural hospitals with cost-based reimbursement for outpatient laboratory services and ambulance services; Provide CAHs bed size flexibility; Reinstate CAH necessary provider status; Remove unreasonable restrictions on CAHs ability to rebuild; Discussions on a bill to credit some observation status days to 3 day inpatient hospital stays; Worked with HHS on establishing the Partnership for Patients Program to improve patient safety activities in hospitals; HR 1929 Emergency Nursing Relief Act, provides for 20,000 additional immigrant visas (green cards) for Registered Nurses, and their immediate family members. Visas issued to the family members would not count against the 20,000 quota. The Secretary of State would not be permitted to issue more visas than this set quota. Employers are charged $1,500 for these visas which would support funding US nursing programs; HR 1933, to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas and calls for a limited revival of the H-1C program; S 778 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 1363 Department of Defense and Further Additional Continuing Appropriations Act, 2011; Letter to oppose Cuts to the funding of the Hospital Preparedness Program.

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 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; HR 1398 Rural Hospital Protection Act, lgislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; Urging congress to establish patient and facility criteria to distinguish LTACHs from other care settings; Raising concerns about CMS flawed methodology that overstate the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; Sessions Crowley and Stabenow Murkowski IPPS letter requesting fixes to the coding offset circulated for signature; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expires in September, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; Worked on legislation related to HIT payments for hospitals in multi-campus systems.

S 217, HR 972 The Secret Ballot Protection Act, makes it an unfair labor practice under the NLRA for an employer to recognize a union that has not been selected via secret ballot and unlawful for a union that has not been chosen as the employees' exclusive rep-resentative in a secret ballot election conducted by the NLRB to cause or attempt to cause an employer to recognize or bargain with it; Urged Rep. Ruppersberger office to request of OFCCP further information about the expanded jurisdiction claimed by the Office over hospitals that participate as in-network providers in TRICARE, FEHBP as federal subcontractors; S. 1253 National Defense Authorization Act for Fiscal Year 2012Supporting provision establishing exemption for TRICARE providers from designation as federal contractors subject to OFCCPs regulations and oversight; encouraging that final bill include this exemption.

S 217, HR 972 The Secret Ballot Protection Act, makes it an unfair labor practice under the NLRA for an employer to recognize a union that has not been selected via secret ballot and unlawful for a union that has not been chosen as the employees' exclusive rep-resentative in a secret ballot election conducted by the NLRB to cause or attempt to cause an employer to recognize or bargain with it; OFCCPs regulatory reach to cover hospitals that participate in TRICARE FEHBP as in-network providers as federal subcontractor

Patient Protection and Affordable Care Act, Maintain the Medicaid maintenance of effort (MOE) provisions; HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 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; Legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; Urging congress to establish patient and facility criteria to distinguish LTACHs from other care settings; Raising concerns about CMS flawed methodology that overstate the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to structure the development of the regulation to implement ACOs prior to release of the proposed rule; Obtaining change in language for Medicare conditions of participation related to governing board requirements to eliminate an unnecessary requirement for separate boards or separate meetings of the board for individual hospitals that are part of a system; Urging CMS not to adopt a burdensome notice requirement in the Medicare conditions of participation related to the grievance process; Urging CMS to update, streamline, and modernize the Medicare conditions of participation.

HR 1, HJ Res 44, and HJRes 48 Budget, additional 2011 Appropriations Amendments; HR1255 Government Shutdown Prevention Act of 2011, to prevent a shutdown of the government of the United States; Maintain funding the Childrens Hospitals Graduate Medical Education program.

S 2 Middle Class Opportunity Act, Card Check provisions; S 45 MCAP Act, 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; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241, a bill to amend title 10, United States Code to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; 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; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill 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; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill 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; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill 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; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse- Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, 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; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts 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 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socio-economic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs; S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comment letter expressing concerns taht ONC's certification criteria for EHR eliminates flexibility CMS established in rule for achieving meaningful use; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake; HR 4700 The Transparency in All Health Care Pricing Act of 2010, to provide for transparency in health care pricing; HR 4803 The Patients Right to Know Act, to ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information; HR 6072 and S 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010, to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 6376 to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; HR 6095 to amend title XVIII of the Social Security Act to preserve integrated care for durable medical equipment under the competitive bidding program for qualified hospital-related DME entities; S 3653 Healthcare Bureacrats Elimination Act, A bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the IPAB.

S 386 Fraud Enforcement and Recovery Act, provisions that would amend the False Claims Act; Requesting DOJ to exercise oversight authority for investigation and enforcement initiatives related to the False Claims Act (e.g. kyphoplasty) initiated by various United States Attorneys.

HR 1409 and S 560 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act; HR 1355 National Labor Relations Modernization Act, provisions related to interest arbitration for first contracts; enhanced employer penalties for certain NLRA violations or alleged violations; and a provision designed to give unions greater access to employees at the employers property; HR 1493 Quality Health Care Coalition Act of 2009, a bill 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; HR 1176 and S 478 The Secret Ballot Protection Act, to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board; S 1681 and HR 3596 Health Insurance Industry Antitrust Enforcement Act of 2009, a bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; S. 1788 and HR 2381 Nurse and Health Care Worker Protection Act of 2009, the bill requires the Secretary of Labor to propose a standard on safe patient handling and injury prevention to prevent musculoskeletal disorders for direct-care registered nurses and all other health care workers that requires the use of engineering controls to lift patients and the elimination of manual lifting of patients through the use of mechanical devices, except where patient care may be compromised; HR 5687 Underserved Area Nursing Relief Restoration Act of 2010, to extend changes to requirements for admission of nonimmigrant nurses in health professional shortage areas made by the Nursing Relief for Disadvantaged Areas Act of 1999.

HR 1105 Omnibus Spending bill for FY 2009, provides $66.3 billion in discretionary funding for HHS programs, a 3% increase from the current level.

HR 27 Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the SCHIP for any fiscal year for certain Medicaid expenditures; HR 465 a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009, a bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals; HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262 Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the MedPAC on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 MedPAC Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the MedPAC, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; H.R. 3138 Physician Payments Sunshine Act of 2009, a bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP; HR 3141 Strengthening the Health Care Safety Net Act of 2009, a bill to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 3152 Helping Seniors Choose their Medicare Drug Plan Act, a bill to amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs; S. 1423 Medicaid Birth Center Reimbursement Act, a bill to amend title XIX of the Social Security Act to require coverage under the Medicaid Program for freestanding birth center services;. 1427 Department of Veterans Affairs Hospital Quality Report Card Act of 2009, a bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Department of Veterans Affairs Medical Centers, and for other purposes; H.R. 3172 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; H.R. 3184 Medicare Independent Living Act of 2009, a bill to amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; H.R. 3356 Medicare Beneficiary Freedom to Choose Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits; H.R. 3361 Medicare Patient Safeguards Act of 2009, a bill to provide a process for public comment and Medicare Evidence Development & Coverage Advisory Committee review of certain Medicare national coverage determinations; HR 3369 and S.1521 Improve Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to require provider payments under Medicare and Medicaid to be made through direct deposit or electronic funds transfer (EFT) at insured depository institutions; S.1522 Outpatient Mental Health Modernization Act of 2009, a bill to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program; H.R. 3374 Medicare and Medicaid Access Project through Information Technology (MAP IT) Act, a bill to provide for a demonstration project relating to the impact of health information technology on chronic disease management under the Medicare and Medicaid programs; H.R. 3430 DSH Collaborative Care Network Pilot Program Act of 2009, a bill to establish a Medicare DSH pilot program under which participants shall establish collaborative care networks to reduce the use of emergency departments, inpatient and other expensive resources of hospitals and other providers and provide more comprehensive and coordinated care to low-income individuals, including those without health insurance coverage, and to establish a Collaborative Care Network Center; Neal Letter to Pelosi, Opposition to the Independent Medicare Advisory Council (IMAC) and MedPAC Reform Act (HR 2718, S1110, S 1380); HR 3556 NO TITLE, a bill to require the Secretary of Health and Human Services to establish a self-referral disclosure protocol under the Medicare Program to enable health care providers of services and suppliers to disclose violations of section 1877 of the Social Security Act; S 1669 Equal Access to Medicare Options Act of 2009, a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy; HR 3631 Medicare Premium Fairness Act, a bill to amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010; HR 3653 Medicare Card Security Act of 2009, a bill to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; HR 3663 NO TITLE, a bill to amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; HR 3665 Ryan White Grantee Medicaid Payment Equity Act of 2009, a bill to amend title XIX of the Social Security Act to provide for payment for Medicaid services furnished by Ryan White part C grantees under a cost-based prospective payment system; HR 3675 National Quality Cancer Care Demonstration Project Act of 2009, a bill to improve the quality and cost effectiveness of cancer care to Medicare beneficiaries by establishing a national demonstration project; HR 2962 Integrity in Medicare Advanced Diagnostic Imaging Act of 2009, a bill to amend title XVIII of the Social Security Act to exclude certain advanced diagnostic imaging services from the in-office ancillary services exception to the prohibition on physician self-referral; HR 3693 Ensuring the Future Physician Workforce Act of 2009, a bill to amend title XVIII of the Social Security Act to modify Medicare physician reimbursement policies to ensure a future physician workforce; HR 3961, HR 4154, S 1600 and Reid amendment 3305 Medicare Physician Payment Reform Act of 2009 and Statutory Pay-As-You-Go Act of 2009, a bill to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians and to reinstitute and update the Pay-As-You-Go requirement of budget neutrality on new tax and mandatory spending legislation, enforced by the threat of annual, automatic sequestration; HR 4250 Medicaid DSH Integrity Act, a bill to direct the Secretary of Health and Human Services to revise regulations implementing the statutory reporting and auditing requirements for the Medicaid disproportionate share hospital ("DSH") payment program to be consistent with the scope of the statutory provisions and avoid substantive changes to preexisting DSH policy; S 1776 Medicare Physician Fairness Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes; S 3000 a bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months; HR 4213 American Workers, State, and Business Relief Act of 2010 a bill that includes an extension of the Recovery Acts increased Federal match for state Medicaid programs. The passed bill extends the increased FMAP through June 30, 2011, which is estimated to provide states with an additional $25.5 billion in FMAP; Letter to Pelosi and Reid expressing opposition to establishment of an Independent Payment Advisory Board (IPAB); Medicaid FMAP ARRA Extension Letter to Senator Reid to include an extension of federal Medicaid assistance to states in legislative proposals to increase employment and rebuild the nations economy; Space, Burgess, Stearns and Engel House Health IT letter and Klobuchar and Hatch Senate Health IT letter to CMS urging a modification of CMS proposed definition of and requirements for hospitals to become qualified as meaningful users of certified electronic health record (EHR) technology; S 3028 Medicare Mental Health Inpatient Equity Act, 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; HR 4872 The Health Care and Education Affordability Reconciliation Act of 2010, to provide for reconciliation pursuant to section 202 of the concurrent resolution on the budget for fiscal year 2010; Meetings with CMS to urge a different interpretation of the Medicare conditions of participation interpretive guidelines on governance which were intepreted to require that each organization with a CCN have a separate governing body, medical staff, etc. in order to be accredited ; HR 5712 Veterans, Seniors, and Childrens Health Technical Corrections Act of 2010 to provide for certain clarifications and extensions under Medicare, Medicaid, and the Children's Health Insurance Program; HR 6005 Ensuring Equality for Early EHR Adoption Act of 2010, to amend titles XVIII and XIX of the Social Security Act to provide for the temporary treatment of certain electronic health records as certified EHR technology for purposes of health information technology payment incentives under the Medicare and Medicaid Programs. Sen. Stabenow and Sen. Murkoswki, Rep. Crowley and Rep. Sessions letter to CMS asking to reevaluate the proposed IPPS regulations that will hit hospital payments in FY 2011; Rep. Pomeroy and Rep. Moran letter to CMS, regarding concerns of the proposed Medicare OPPS regulation for FY 2011 does not show continued access to full range of outpatient therapeutic services for small, rural & CAH hospitals; Discussion with CMS about implementation of the self-referral disclosure protocol; HR 5712 Veterans, Seniors, and Childrens Health Technical Corrections Act of 2010 or Physician Payment and Therapy Relief Act of 2010, to provide for certain clarifications and extensions under Medicare, Medicaid, and the Children's Health Insurance Program; HR 6005 Ensuring Equality for Early EHR Adoption Act of 2010, to amend titles XVIII and XIX of the Social Security Act to provide for the temporary treatment of certain electronic health records as certified EHR technology for purposes of health information technology payment incentives under the Medicare and Medicaid Programs.

Limited English Proficiency - Advocated for translation of the various Medicare forms and notices into the top 15 non-English languages. Urged exploration of opportunities via Medicare and demonstration programs to examine language access issues. Urged creation database related to language access information and translation services. Urged reimbursement for language services as part of Medicare. Mtg at WH about limitations of the civil money penalties law for follow-up services and the clinical integration of care.

HR 2221 and S 3742Data Security and Breach Notification Act of 2010, exception from bills provisions for HIPAA covered entities which are already subject to substantially similar requirements under existing HIPAA regulations.

HR 2221 and S 3742Data Security and Breach Notification Act of 2010, exception from bills provisions for HIPAA covered entities which are already subject to substantially similar requirements under existing HIPAA regulations.

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, 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; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; 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; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, 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; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill 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; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill 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; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill 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; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, 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; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts 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 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake; HR 4700 The Transparency in All Health Care Pricing Act of 2010, to provide for transparency in health care pricing; HR 4803 The Patients Right to Know Act, to ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information; HR 6072 and S 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010, to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 6376 to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services

Limited English Proficiency - Advocated for translation of the various Medicare forms and notices into the top 15 non-English languages. Urged exploration of opportunities via Medicare and demonstration programs to examine language access issues. Urged creation database related to language access information and translation services. Urged reimbursement for language services as part of Medicare.

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts; Letter to IRS urging the Internal Revenue Service to improve its new Schedule H to better reflect the benefits non-profit hospitals systems provide to their communities; Meetings with IRS re implementation of the provisions of IRC 501(r) enacted as part of the PPACA and Schedule H reporting by hospitals that are part of health care systems.

S 386 Fraud Enforcement and Recovery Act, provisions that would amend the False Claims Act

HR 1409 and S 560 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act; HR 1355 National Labor Relations Modernization Act, provisions related to interest arbitration for first contracts; enhanced employer penalties for certain NLRA violations or alleged violations; and a provision designed to give unions greater access to employees at the employers property; HR 1493 Quality Health Care Coalition Act of 2009, a bill 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; HR 1176 and S 478 The Secret Ballot Protection Act, to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board; Discussion with DOJ about AHA white paper on Clinical Integration and antitrust barriers to clinical integration; Discussions with DOJ about the implications for hospitals of insurance industry mergers; S 1681 and HR 3596 Health Insurance Industry Antitrust Enforcement Act of 2009, a bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; S. 1788 and HR 2381 Nurse and Health Care Worker Protection Act of 2009, the bill requires the Secretary of Labor to propose a standard on safe patient handling and injury prevention to prevent musculoskeletal disorders for direct-care registered nurses and all other health care workers that requires the use of engineering controls to lift patients and the elimination of manual lifting of patients through the use of mechanical devices, except where patient care may be compromised; HR 5687Underserved Area Nursing Relief Restoration Act of 2010, to extend changes to requirements for admission of nonimmigrant nurses in health professional shortage areas made by the Nursing Relief for Disadvantaged Areas Act of 1999.

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, 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; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; 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; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, 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; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill 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; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill 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; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill 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; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, 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; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts 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 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake; HR 4700 The Transparency in All Health Care Pricing Act of 2010, to provide for transparency in health care pricing; HR 4803 The Patients Right to Know Act, to ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information.

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts; Letter to IRS urging the Internal Revenue Service to improve its new Schedule H to better reflect the benefits non-profit hospitals systems provide to their communities.

HR 1409 and S 560 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act; HR 1355 National Labor Relations Modernization Act, provisions related to interest arbitration for first contracts; enhanced employer penalties for certain NLRA violations or alleged violations; and a provision designed to give unions greater access to employees at the employers property; HR 1493 Quality Health Care Coalition Act of 2009, a bill 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; HR 1176 and S 478 The Secret Ballot Protection Act, to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board; Discussion with DOJ about AHA white paper on Clinical Integration and antitrust barriers to clinical integration; Discussions with DOJ about the implications for hospitals of insurance industry mergers; S 1681 and HR 3596 Health Insurance Industry Antitrust Enforcement Act of 2009, a bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; S. 1788 and HR 2381 Nurse and Health Care Worker Protection Act of 2009, the bill requires the Secretary of Labor to propose a standard on safe patient handling and injury prevention to prevent musculoskeletal disorders for direct-care registered nurses and all other health care workers that requires the use of engineering controls to lift patients and the elimination of manual lifting of patients through the use of mechanical devices, except where patient care may be compromised.

S 386 Fraud Enforcement and Recovery Act, provisions that would amend the False Claims Act

Limited English Proficiency - Advocated for translation of the various Medicare forms and notices into the top 15 non-English languages. Urged exploration of opportunities via Medicare and demonstration programs to examine language access issues. Urged creation database related to language access information and translation services. Urged reimbursement for language services as part of Medicare.

HR 1105 Omnibus Spending bill for FY 2009, provides $66.3 billion in discretionary funding for HHS programs, a 3% increase from the current level; H Con Res 85 and S Con Res 132010 budget resolution, setting forth the congressional budget for the US Government for fiscal year 2010 and including the appropriate budgetery levels for fiscal years thru 2014; HR 3293 Department of Education Appropriations Act, 2010, Department of Health and Human Services Appropriations Act, 2010, Department of Labor Appropriations Act, 2010, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2010, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2010; 2011Y Presidents Budget, HEALTH: The Presidents budget includes a placeholder for healthcare reform instead of specific proposals. His health insurance reform allowance reflects a $127 billion net deficit decrease over five years and $150 billion net deficit decrease over ten years, which is described as the average budget impacts of the House- and Senate-passed health care reform bills, extrapolated to 2020 and adjusted to remove the effects of provisions explicitly listed elsewhere in the budget; .

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts; Letter to IRS urging the Internal Revenue Service to improve its new Schedule H to better reflect the benefits non-profit hospitals provide to their communities.

HR 1409 and S 560 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act; HR 1355 National Labor Relations Modernization Act, provisions related to interest arbitration for first contracts; enhanced employer penalties for certain NLRA violations or alleged violations; and a provision designed to give unions greater access to employees at the employers property; HR 1493 Quality Health Care Coalition Act of 2009, a bill 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; HR 1176 and S 478 The Secret Ballot Protection Act, to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board; Discussion with DOJ about AHA white paper on Clinical Integration and antitrust barriers to clinical integration; Discussions with DOJ about the implications for hospitals of insurance industry mergers; S 1681 and HR 3596 Health Insurance Industry Antitrust Enforcement Act of 2009, a bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; S. 1788 and HR 2381 Nurse and Health Care Worker Protection Act of 2009, the bill requires the Secretary of Labor to propose a standard on safe patient handling and injury prevention to prevent musculoskeletal disorders for direct-care registered nurses and all other health care workers that requires the use of engineering controls to lift patients and the elimination of manual lifting of patients through the use of mechanical devices, except where patient care may be compromised.

HR 27 Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the SCHIP for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465 a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a CMS Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS); Working on legislation to amend the Medicare Recovery Audit Contractor Program; S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and(d) of section 114 of the Medicare, Medicaid, & SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letters and further discussions to CMS, Physician Supervision for Outpatient Service, resend policy changes requiring direct physician supervision for all PSO therapeutic Outpatient Service provided in and on hospital campus under Medicare, and withdraw change to minimize legal risk for years 2001-2009; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009, a bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals; HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262 Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the MedPAC on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 MedPAC Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the MedPAC, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; H.R. 3138 Physician Payments Sunshine Act of 2009, a bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP; HR 3141 Strengthening the Health Care Safety Net Act of 2009, a bill to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 3152 Helping Seniors Choose their Medicare Drug Plan Act, a bill to amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs; S. 1423 Medicaid Birth Center Reimbursement Act, a bill to amend title XIX of the Social Security Act to require coverage under the Medicaid Program for freestanding birth center services; S. 1427 Department of Veterans Affairs Hospital Quality Report Card Act of 2009, a bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Department of Veterans Affairs Medical Centers, and for other purposes; H.R. 3172 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; H.R. 3184 Medicare Independent Living Act of 2009, a bill to amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; H.R. 3256 Rural Community Hospital Demonstration Extension Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; H.R. 3356 Medicare Beneficiary Freedom to Choose Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits; H.R. 3361 Medicare Patient Safeguards Act of 2009, a bill to provide a process for public comment and Medicare Evidence Development & Coverage Advisory Committee review of certain Medicare national coverage determinations, and for other purposes; HR 3369 and S.1521 Improve Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to require provider payments under Medicare and Medicaid to be made through direct deposit or electronic funds transfer (EFT) at insured depository institutions; S.1522 Outpatient Mental Health Modernization Act of 2009, a bill to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program; H.R. 3374 Medicare and Medicaid Access Project through Information Technology (MAP IT) Act, a bill to provide for a demonstration project relating to the impact of health information technology on chronic disease management under the Medicare and Medicaid programs; H.R. 3422 Medicare Support for Rural Hospitals Act, a bill to amend title XVIII of the Social Security Act to make temporary improvements to the Medicare inpatient payment adjustment for low-volume hospitals; H.R. 3430 DSH Collaborative Care Network Pilot Program Act of 2009, a bill to establish a Medicare DSH pilot program under which participants shall establish collaborative care networks to reduce the use of emergency departments, inpatient and other expensive resources of hospitals and other providers and provide more comprehensive and coordinated care to low-income individuals, including those without health insurance coverage, and to establish a Collaborative Care Network Center; Neal Letter to Pelosi, Opposition to the Independent Medicare Advisory Council (IMAC) and MedPAC Reform Act (HR 2718, S1110, S 1380); HR 3556 NO TITLE, a bill to require the Secretary of Health and Human Services to establish a self-referral disclosure protocol under the Medicare Program to enable health care providers of services and suppliers to disclose violations of section 1877 of the Social Security Act; S 1669 Equal Access to Medicare Options Act of 2009, a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy; HR 3631 Medicare Premium Fairness Act, a bill to amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010; HR 3653 Medicare Card Security Act of 2009, a bill to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; HR 3663 NO TITLE, a bill to amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; HR 3665 Ryan White Grantee Medicaid Payment Equity Act of 2009, a bill to amend title XIX of the Social Security Act to provide for payment for Medicaid services furnished by Ryan White part C grantees under a cost-based prospective payment system; HR 3675 National Quality Cancer Care Demonstration Project Act of 2009, a bill to improve the quality and cost effectiveness of cancer care to Medicare beneficiaries by establishing a national demonstration project; HR 2962 Integrity in Medicare Advanced Diagnostic Imaging Act of 2009, a bill to amend title XVIII of the Social Security Act to exclude certain advanced diagnostic imaging services from the in-office ancillary services exception to the prohibition on physician self-referral; Meeting with CMS re implementation of new requirements for insurance providers to report payment responsibility for Medicare Secondary Payer program; HR 3693 Ensuring the Future Physician Workforce Act of 2009, a bill to amend title XVIII of the Social Security Act to modify Medicare physician reimbursement policies to ensure a future physician workforce; HR 3961, HR 4154, S 1600 and Reid amendment 3305 Medicare Physician Payment Reform Act of 2009 and Statutory Pay-As-You-Go Act of 2009, a bill to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians and to reinstitute and update the Pay-As-You-Go requirement of budget neutrality on new tax and mandatory spending legislation, enforced by the threat of annual, automatic sequestration; HR 4250 Medicaid DSH Integrity Act, a bill to direct the Secretary of Health and Human Services to revise regulations implementing the statutory reporting and auditing requirements for the Medicaid disproportionate share hospital ("DSH") payment program to be consistent with the scope of the statutory provisions and avoid substantive changes to preexisting DSH policy; S 1776 Medicare Physician Fairness Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes; discussion with the HHS Office of the National Coordinator for Health Information Technology of hospital concerns around development of requirements for meaningful use of Electronic Health Records (EHR) to qualify for Medicare and Medicaid incentive payments for EHR development; S 3000 a bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months; HR 4213 American Workers, State, and Business Relief Act of 2010 a bill that includes an extension of the Recovery Acts increased Federal match for state Medicaid programs. The passed bill extends the increased FMAP through June 30, 2011, which is estimated to provide states with an additional $25.5 billion in FMAP; Letter to Pelosi and Reid expressing opposition to establishment of an Independent Payment Advisory Board (IPAB); Medicaid FMAP ARRA Extension Letter to Senator Reid to include an extension of federal Medicaid assistance to states in legislative proposals to increase employment and rebuild the nations economy; Space, Burgess, Stearns and Engel House Health IT letter and Klobuchar and Hatch Senate Health IT letter to CMS urging a modification of CMS proposed definition of and requirements for hospitals to become qualified as meaningful users of certified electronic health record (EHR) technology; S 3028 Medicare Mental Health Inpatient Equity Act, 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; HR 4872 The Health Care and Education Affordability Reconciliation Act of 2010, to provide for reconciliation pursuant to section 202 of the concurrent resolution on the budget for fiscal year 2010; Meetings with CMS to urge a different interpretation of the Medicare conditions of participation interpretive guidelines, as currently interpreted guidelines would require accreditation of each hospital as a standalone entity and require them to each have a separate governing body, medical staff, etc. in order to be accredited by the joint commission.

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts.

HR 1105 Omnibus Spending bill for FY 2009, provides $66.3 billion in discretionary funding for HHS programs, a 3% increase from the current level; H Con Res 85 and S Con Res 132010 budget resolution, setting forth the congressional budget for the US Government for fiscal year 2010 and including the appropriate budgetery levels for fiscal years thru 2014; HR 3293 Department of Education Appropriations Act, 2010, Department of Health and Human Services Appropriations Act, 2010, Department of Labor Appropriations Act, 2010, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2010, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2010.

HR 1409 and S 560 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act; HR 1355 National Labor Relations Modernization Act, provisions related to interest arbitration for first contracts; enhanced employer penalties for certain NLRA violations or alleged violations; and a provision designed to give unions greater access to employees at the employers property; HR 1493 Quality Health Care Coalition Act of 2009, a bill 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; HR 1176 and S 478 The Secret Ballot Protection Act, to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board; Discussion with DOJ about AHA white paper on Clinical Integration and antitrust barriers to clinical integration; Discussions with DOJ about the implications for hospitals of insurance industry mergers; S 1681 and HR 3596 Health Insurance Industry Antitrust Enforcement Act of 2009, a bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers.

Brady/ Wilson Hospital Stimulus Letter to Obama Administration - Working with Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) urging their House colleagues to sign a letter asking the President to include relief for hospitals in the plan; HR 1 and S 1 American Recovery and Reinvestment Tax Act of 2009, HR 598 Assistance for Unemployed Workers and Struggling Families Act, HR 629 Health Information Technology for Economic and Clinical Health Act, S 350 Health Insurance Assistance for the Unemployed Act of 2009; HITECH Act Energy and Commerce Recovery and Reinvestment Act, all bills related to issues in the Economic Stimulus Bill pertaining to FMAP increase, DSH payments, moratoria through June 30 on Medicaid provider tax regs and hospital outpatient services, Medicare teaching hospitals IME, long-term care hospitals, health IT, tax exempt bonds, and provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health; HR 2 and S 275 Children's Health Insurance Program Reauthorization Act of 2009, provisions to secure health care coverage for more than 7 million low-income children currently covered by the State Childrens Health Insurance Program (SCHIP), to add coverage to nearly 4 million more, to improve coverage of dental and mental health benefits for children and to eliminate the five-year waiting period for coverage under SCHIP of legal immigrant children and pregnant women; S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, 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; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; 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; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, 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; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill 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; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill 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; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill 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; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, 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; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts 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 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals.

HR 1105 Omnibus Spending bill for FY 2009, provides $66.3 billion in discretionary funding for HHS programs, a 3% increase from the current level; H Con Res 85 and S Con Res 132010 budget resolution, setting forth the congressional budget for the US Government for fiscal year 2010 and including the appropriate budgetery levels for fiscal years thru 2014; HR 3293 Department of Education Appropriations Act, 2010, Department of Health and Human Services Appropriations Act, 2010, Department of Labor Appropriations Act, 2010, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2010, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2010.

HR 1409 and S 560 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act; HR 1355 National Labor Relations Modernization Act, provisions related to interest arbitration for first contracts; enhanced employer penalties for certain NLRA violations or alleged violations; and a provision designed to give unions greater access to employees at the employers property; HR 1493 Quality Health Care Coalition Act of 2009, a bill 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; HR 1176 and S 478 The Secret Ballot Protection Act, to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board; Discussion with DOJ about AHA white paper on Clinical Integration and antitrust barriers to clinical integration; Discussions with DOJ about the implications for hospitals of insurance industry mergers.

S 386 Fraud Enforcement and Recovery Act, provisions that would amend the False Claims Act

Brady/ Wilson Hospital Stimulus Letter to Obama Administration - Working with Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) urging their House colleagues to sign a letter asking the President to include relief for hospitals in the plan; HR 1 and S 1 American Recovery and Reinvestment Tax Act of 2009, HR 598 Assistance for Unemployed Workers and Struggling Families Act, HR 629 Health Information Technology for Economic and Clinical Health Act, S 350 Health Insurance Assistance for the Unemployed Act of 2009; HITECH Act Energy and Commerce Recovery and Reinvestment Act, all bills related to issues in the Economic Stimulus Bill pertaining to FMAP increase, DSH payments, moratoria through June 30 on Medicaid provider tax regs and hospital outpatient services, Medicare teaching hospitals IME, long-term care hospitals, health IT, tax exempt bonds, and provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health; HR 2 and S 275 Children's Health Insurance Program Reauthorization Act of 2009, provisions to secure health care coverage for more than 7 million low-income children currently covered by the State Childrens Health Insurance Program (SCHIP), to add coverage to nearly 4 million more, to improve coverage of dental and mental health benefits for children and to eliminate the five-year waiting period for coverage under SCHIP of legal immigrant children and pregnant women; S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, 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; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; 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; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, 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; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill 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; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill 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; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill 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; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; Disclosure of Financial Relationships Report, argue for withdrawal of data collection form; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, 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; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts 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 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; S 1681Health Insurance Industry Antitrust Enforcement Act of 2009, a bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing.

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts.

Brady/ Wilson Hospital Stimulus Letter to Obama Administration - Working with Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) urging their House colleagues to sign a letter asking the President to include relief for hospitals in the plan; HR 1 and S 1 American Recovery and Reinvestment Tax Act of 2009, HR 598 Assistance for Unemployed Workers and Struggling Families Act, HR 629 Health Information Technology for Economic and Clinical Health Act, S 350 Health Insurance Assistance for the Unemployed Act of 2009; HITECH Act Energy and Commerce Recovery and Reinvestment Act, all bills related to issues in the Economic Stimulus Bill pertaining to FMAP increase, DSH payments, moratoria through June 30 on Medicaid provider tax regs and hospital outpatient services, Medicare teaching hospitals IME, long-term care hospitals, health IT, tax exempt bonds, and provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health; HR 2 and S 275 Children's Health Insurance Program Reauthorization Act of 2009, this bill will secure health care coverage for more than 7 million low-income children currently covered by the State Childrens Health Insurance Program (SCHIP) and add coverage to nearly 4 million more. It also contains provisions to improve coverage of dental and mental health benefits for children and to eliminate the five-year waiting period for coverage under SCHIP of legal immigrant children and pregnant women; S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, 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; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; 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; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, would prohibit health insurers from denying coverage to people with pre-existing conditions, such as diabetes and heart disease; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, 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; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176Nursing and Allied Health Education Preservation Act of 2009A bill to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957Public Health Emergency Response Act of 2009A bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill 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; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill 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; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2292 Healthy Kids for Healthy Futures Act of 2009A bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050Informed Consumer Choices in Health Care Act of 2009, a bill 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; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; Disclosure of Financial Relationships Report, argue for withdrawal of data collection form; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824Doctor-Patient Relationship and Research Protection ActTo enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, 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; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections, such as MRSA; Hatch amendment # 21 requires the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; Health Reform Bill, pProvides access to quality affordable health care for all. The health reform package includes: ACCESS TO COVERAGE AND CHOICE, AFFORDABILITY, SHARED RESPONSIBILITY, CONTROLLING COSTS, PREVENTION AND WELLNESS, WORKFORCE INVESTMENTS; HR 2962 Integrity in Medicare Advanced Diagnostic Imaging Act of 2009, a bill to amend title XVIII of the Social Security Act to exclude certain advanced diagnostic imaging services from the in-office ancillary services exception to the prohibition on physician self-referral; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, 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; S 1355Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas.

HR 27Medicare Fraud Prevention and Enforcement Act of 2009, a bill to amend title XVIII of the Social Security Act to establish additional provisions to combat waste, fraud, and abuse within the Medicare Program, and for other purposes; HR 43 and S 46, Medicare Access to Rehabilitation Services Act of 2009, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; S 54 Registered Nurse Safe Staffing Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes; HR 319 Legal Immigrant Children's Health Improvement Act of 2009, a bill to amend titles XIX and XXI of the Social Security Act to permit States the option of coverage of legal immigrants under the Medicaid Program and the State children's health insurance program (SCHIP); S 214 Children's Health Equity Technical Amendments Act of 2009, a bill to amend title XXI of the Social Security Act to permit qualifying States to use their allotments under the State Children's Health Insurance Program for any fiscal year for certain Medicaid expenditures; HR 362 and S 318 Medicare Rural Health Access Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas; HR 465,a bill to amend titles XIX and XXI of the Social Security Act to permit States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP; HR 487, a bill to waive the 35-mile requirement for designation of a critical access hospital under the Medicare program; HR 592 and S 264 E-Centives Act of 2009, a bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid Program and the Children's Health Insurance Program, and for other purposes; HR 619 a bill to amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases; S 295 Medicare Quality and Payment Reform Act of 2009, to amend title XVIII of the Social Security Act to improve the quality and efficiency of the Medicare program through measurement of readmission rates and resource use and to develop a pilot program to provide episodic payments to organized groups of multispecialty and multilevel providers of services and suppliers for hospitalization episodes associated with select, high cost diagnoses; HR 668 and S 307 Critical Access Hospital Flexibility Act of 2009, a bill to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program and to exempt from the critical access hospital inpatient bed limitation the number of beds provided for certain veterans; HR 902 and S. 382 MediFair Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in States with more cost-effective health care delivery systems; S 434 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; S 438 Improved Medical Decision Incentive Act of 2009, a bill to provide for the voluntary development by States of qualifying best practices for health care and to encourage such voluntary development by amending titles XVIII and XIX of the Social Security Act to provide differential rates of payment favoring treatment provided consistent with qualifying best practices under the Medicare and Medicaid programs, and for other purposes; HR 1117 Medically Fragile Children's Act of 2009, a bill to amend title XIX of the Social Security Act to establish a State plan option under Medicaid to provide an all-inclusive program of care for children who are medically fragile or have one or more chronic conditions that impede their ability to function; HR 1188 and S 468 Access to Emergency Medical Services Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to emergency medical services and the quality and efficiency of care furnished in emergency departments of hospitals and critical access hospitals by establishing a bipartisan commission to examine factors that affect the effective delivery of such services, by providing for additional payments for certain physician services furnished in such emergency departments, and by establishing a Centers for Medicare & Medicaid Services Working Group, and for other purposes; S 712 Rural Medicare Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to improve the Medicare program for beneficiaries residing in rural areas; HR 1776 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2009, a bill to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; Senator Schumer and Senator Roberts Letter eliminating IME Cuts CMS to withdraw the Capital IME cut that was included in last years Medicare IPPS rule; Letter to President Obama from Neal/ Tiberi on Capital IME PROTECT AMERICAS TEACHING HOSPITALS, asking him to withdraw a provision in the FY 2010 IPPS rule that would cut reimbursements to teaching hospitals. Letter to CMS asking to eliminate the state-specific budget neutrality policy for the rural and imputed rural floor indices in the upcoming FY2010 Inpatient Prospective Payment System Rule (IPPS).Working on legislation to amend the Medicare Recovery Audit Contractor Program. S 852 a bill to apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters; HR 2068 Medicare Telehealth Enhancement Act of 2009, a bill to improve the provision of telehealth services under the Medicare Program; HR 2094 Physician Training Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to increase the per resident payment floor for direct graduate medical education payments under the Medicare Program; HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare Program; HR 2204 Medicare Access to Rural Anesthesiology Act of 2009, a bill to amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals; S 935 Medicare Long-Term Care Hospital Improvement Act of 2009, a bill to extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to provide for regulatory stability during the development of facility and patient criteria for long-term care hospitals under the Medicare program; HR 2443 Medicare Ambulance Access Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to ambulance services under the Medicare Program; S 1079 Medicare Cost Contract Extension and Refinement Act of 2009, a bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program; HR 2525 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; HR 2534 Physician Pathology Services Continuity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; S 1108 Safeguarding Our Hospitals' Futures Act of 2009, a bill to require application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor for each all-urban and rural State; S 1110 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1114 Medical Homes Act of 2009, a bill to establish a demonstration project to provide for patient-centered medical homes to improve the effectiveness and efficiency in providing medical assistance under the Medicaid program and child health assistance under the State Children's Health Insurance Program; Letter to CMS, Physician Supervision for Outpatient Service, Resend policy changes requiring PSO therapeutic Service in and on hospital campus. Withdraw it to minimize legal risk; HR 2688 Empowered at Home Act of 2009, a bill to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program; HR 2692 and S 1171CAH Designation Waiver Authority Act of 2009A bill to amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program; HR 2718 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy; S 1185 Medicare Financial Stability for Beneficiaries Act of 2009, a bill to amend titles XVIII and XIX of the Social Security Act to ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs; S 1181 Healthy Living and Health Aging Demonstration Project Act of 2009, a bill to provide for a demonstration project to examine whether community-level public health interventions can result in lower rates of chronic disease for individuals entering the Medicare program; HR 2753 a bill to delay the implementation of new Medicare hospital geographic wage reclassification criteria until the Secretary of Health and Human Services issues a proposal to revise the hospital wage index classification system that addresses certain considerations; HR 2758 Medicare Specialty Care Improvement and Protection Act of 2009, a bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes HR 2773 Medicare Transitional Care Act of 2009, a bill to amend title XVIII of the Social Security Act to cover transitional care services to improve the quality and cost effectiveness of care under the Medicare Program; S 1218 Urban Medicare-Dependent Hospitals Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals; HR 2784 Partnership to Improve Seniors Access to Medicare Act, a bill to establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program; HR 2805 Ensuring Continuous Medicaid Coverage for Children Act of 2009, a bill to amend title XIX of the Social Security Act to require 12-month continuous coverage for children under Medicaid; HR 2844 Medicare Payment Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule; HR 2859 Strengthening Medicaid for America's Children Act of 2009, a bill to amend title XIX of the Social Security Act to provide for application of an enhanced Federal matching rate for children under the Medicaid Program if certain conditions are met; S 1262Medical Efficiency and Delivery Improvement of Care Act (MEDIC) of 2009, a bill to amend title VII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to provide additional resources for primary care services, to create new payment models for services under Medicare, to expand provision of non-institutionally-based long-term services, and for other purposes; S 1263 Senior Navigation and Planning Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for advanced illness care management services for Medicare beneficiaries, and for other purposes; HR 2919 Medicare Efficiency Incentive Act of 2009, a bill to amend part B of title XVIII of the Social Security Act to provide Medicare physician incentive payments for efficient areas; HR 2921a bill to amend title XVIII of the Social Security Act to provide for an annual review by the Medicare Payment Advisory Commission on geographic access to services; S 1279 TARP Recipient Ownership Trust Act of 2009, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program; HR 2959 Accountable Care Promotion Act of 2009, a bill to amend title XVIII of the Social Security Act to establish an accountable care organization pilot program to reduce the growth of expenditures and improve health outcomes under the Medicare Program; S 1300 Community and Rural Medical Residency Preservation Act of 2009, a bill to amend title XVIII of the Social Security Act to clarify intent regarding the counting of residents in a nonhospital setting under the Medicare program; S 1380 Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009, a bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy.

HR 1409 and S 560 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act; HR 1355 National Labor Relations Modernization Act, the bill includes 3 provisions: interest arbitration for first contracts; enhanced employer penalties for certain NLRA violations or alleged violations; and a provision designed to give unions greater access to employees at the employers property; HR 1493 Quality Health Care Coalition Act of 2009, a bill 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; HR 1176 and S 478 The Secret Ballot Protection Act, to amend the National Labor Relations Act to ensure the right of employees to a secret-ballot election conducted by the National Labor Relations Board will ensure that workers in an appropriate collective bargaining unit are able to cast their votes on unionization in private, free from undue pressure or influence.

HR 1105 Omnibus Spending bill for FY 2009, provides $66.3 billion in discretionary funding for HHS programs, a 3% increase from the current level; H Con Res 85 and S Con Res 132010 budget resolution, setting forth the congressional budget for the US Government for fiscal year 2010 and including the appropriate budgetery levels for fiscal years thru 2014.

S 386 Fraud Enforcement and Recovery Act, includes provisions that would amend the False Claims Act

Brady/ Wilson Hospital Stimulus Letter to Obama Administration - Working with Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) urging their House colleagues to sign a letter asking the President to include relief for hospitals in the plan; HR 1 and S 1 American Recovery and Reinvestment Tax Act of 2009, HR 598 Assistance for Unemployed Workers and Struggling Families Act, HR 629 Health Information Technology for Economic and Clinical Health Act, S 350 Health Insurance Assistance for the Unemployed Act of 2009; HITECH Act Energy and Commerce Recovery and Reinvestment Act, all bills related to issues in the Economic Stimulus Bill pertaining to FMAP increase, DSH payments, moratoria through June 30 on Medicaid provider tax regs and hospital outpatient services, Medicare teaching hospitals IME, long-term care hospitals, health IT, tax exempt bonds, and provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health; HR 2 and S 275 Children's Health Insurance Program Reauthorization Act of 2009, this bill will secure health care coverage for more than 7 million low-income children currently covered by the State Childrens Health Insurance Program (SCHIP) and add coverage to nearly 4 million more. It also contains provisions to improve coverage of dental and mental health benefits for children and to eliminate the five-year waiting period for coverage under SCHIP of legal immigrant children and pregnant women; S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, 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; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 464 More Children, More Choices Act of 2009, a bill to provide for a 5-year SCHIP reauthorization for coverage of low-income children, an expansion of child health care insurance coverage through tax fairness, and a health care Federalism initiative, and for other purposes; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1075 RECOVER Act (Restoring Essential Care for Our Veterans for Effective Recovery), a bill to amend title 38, United States Code, to expand access to hospital care for veterans in major disaster areas, and for other purposes; HR 1085Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; 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; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1092 No Discrimination in Health Insurance Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, Public Health Service Act, and the Internal Revenue Code of 1986 to prohibit discrimination in group health coverage and individual health insurance coverage; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 442 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; S 491 Federal and Military Retiree Health Care Equity Act, a bill to amend the Internal Revenue Code of 1986 to allow Federal civilian and military retirees to pay health insurance premiums on a pretax basis and to allow a deduction for TRICARE supplemental premiums; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, would prohibit health insurers from denying coverage to people with pre-existing conditions, such as diabetes and heart disease; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; HR 1591 Fulfilling America's Promise to Our Veterans Act, a bill to amend title 38, United States Code, to clarify that the United States may not recover or collect any charges from a third party for hospital care or medical services provided by the Secretary of Veterans Affairs to a veteran for a service-connected disability; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; S 658 Rural Veterans Health Care Improvement Act of 2009, a bill to amend title 38, United States Code, to improve health care for veterans who live in rural areas; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, 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; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; S 734 Rural Veterans Health Care Access and Quality Act of 2009, a bill to amend title 38, United States Code, to improve the capacity of the Department of Veterans Affairs to recruit and retain physicians in Health Professional Shortage Areas and to improve the provision of health care to veterans in rural areas; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency.

H.R. 4854 and S. 2041 False Claims Act Correction Act of 2007, all provisions to amend the False Claims Act

S. 2908 Medicare Card Security Act of 2008, to amend title II of the Social Security Act to prohibit the display of Social Security account numbers on Medicare cards; H.R. 5442 TRUST in Health Information Act of 2008, to provide individuals with access to health information of which they are a subject, to ensure personal privacy, security, and confidentiality with respect to health related information in promoting the development of a nationwide interoperable health information infrastructure, to impose criminal and civil penalties for unauthorized use of personal health information, to provide for the strong enforcement of these rights, to protect States' rights, and for other purposes; S. 1814 Health Information Privacy and Security Act, a bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiable information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights; H.R. 6179 Promoting Health Information Technology Act of 2008, to encourage and enhance the adoption of interoperable health information technology to improve health care quality, reduce medical errors, and increase the efficiency of care; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008, to amend the Public Health Service Act to promote the adoption of health information technology, and for other purposes; H.R. 6898 Health-e Information Technology Act of 2008, to promote the adoption and meaningful use of health information technology, and for other purposes.

H.R. 800 and S. 1041 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; H.R. 1644 and S. 969 RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act.

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program; H.R. 6912 and S. 3300 Rural Hospital Assistance Act of 2008, to amend title XVIII of the Social Security Act to provide for temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals and to provide for the use of the non-wage adjusted PPS rate under the Medicare-dependent hospital (MDH) program, and for other purposes; S. 3327 Empowered at Home Act of 2008, to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; H.R. 6394 Border Health Care Relief Act of 2008, to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend Federal reimbursement of emergency health services furnished to undocumented aliens, and for other purposes; S. 3367, to amend title XVIII of the Social Security Act to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program; S. 3656 and H.R. 7241 Preserving Access to Healthcare (PATH) Act of 2008, a bill to preserve access to healthcare under the Medicare and Medicaid programs. The sections related to the Medicare indirect medical education adjustment factor and the delay in implementation of Medicaid outpatient hospital services regulation; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H. R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008, to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; H. R. 6966 and S. 3582 Safeguarding Our Hospitals' Futures Act of 2008, all provisions to require continued application of budget neutrality on a national basis in calculation of the Medicare urban hospital wage floor.

S. 2672 Conrad State 30 Improvement Act, all provisions to provide incentives to physicians to practice in rural and medically underserved communities; H.R. 5924 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States, and for other purposes.

S. 2672 Conrad State 30 Improvement Act, all provisions to provide incentives to physicians to practice in rural and medically underserved communities; H.R. 5924 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States, and for other purposes.

Issues pertaining to coverage and other health issues; H.R. 1424 Paul Wellstone Mental Health and Addiction Equity Act of 2007, Sec. 2, 3, 5 and 6 and all provisions relating to physician-owned hospitals as well as mental health parity; S. 558 Mental Health Parity Act of 2007, all provisions related to mental health parity; H.R. 1666 Health Care Price Transparency Promotion Act of 2007, all provisions 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; S. 866 Health Promotion First Act, all provisions pertaining to health promotion reearch and dissemination; S. 1893 Children's Health Insurance Program Reauthorization Act of 2007, all provisions related to this bill; H.R. 2851 and S. 400 Michelle's Law, all provisions to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to ensure that dependent students who take a medically necessary leave of absence do not lose health insurance coverage, and for other purposes; H.R. 5544 Patients and Public Health Partnership Act of 2008, all provisions to amend the Public Health Service Act to authorize a demonstration project for integrated health systems to expand access to primary and preventive care for the medically underserved, and for other purposes; H.R. 2606 340B Program Improvement and Integrity Act of 2007, all provisions to amend section 340B of the Public Health Service Act to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers; S. 334 Healthy Americans Act, all provisions to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; H.R. 5885 Health Information Technology Promotion Act of 2008, to promote a better health information system; H.R. 5739 Physician Availability Act of 2008, to assure that the services of a non-emergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; H.R. 1174 Healthy Hospitals Act of 2007, to amend title XVIII of the Social Security Act to require public reporting of health care-associated infections data by hospitals and ambulatory surgical centers and to permit the Secretary of Health and Human Services to establish a pilot program to provide incentives to hospitals and ambulatory surgical centers to eliminate the rate of occurrence of such infections; H.R. 5942 National Trauma Center Stabilization Act of 2008, to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; H.R. 3014 Health Equity and Accountability Act of 2007, to improve the health of minority individuals, and for other purposes; H.R. 6444 Healthy Americans Act, to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away H.R. 6049 Energy and Tax Extenders Act of 2008, Section 255 Parity in the application of certain limits to mental health benefits; issue seeking withdrawal of proposed rule and re-issuance of revised rule related to Tri-Care outpatient prospective payment system; issues pertaining to physician self-referral and physician ownership.

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program; H.R. 6912 and S. 3300 Rural Hospital Assistance Act of 2008, to amend title XVIII of the Social Security Act to provide for temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals and to provide for the use of the non-wage adjusted PPS rate under the Medicare-dependent hospital (MDH) program, and for other purposes; S. 3327 Empowered at Home Act of 2008, to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; H.R. 6394 Border Health Care Relief Act of 2008, to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend Federal reimbursement of emergency health services furnished to undocumented aliens, and for other purposes; S. 3367, to amend title XVIII of the Social Security Act to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program; S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, a bill to preserve access to healthcare under the Medicare and Medicaid programs. The sections related to the Medicare indirect medical education adjustment factor and the delay in implementation of Medicaid outpatient hospital services regulation; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H. R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008, to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; H. R. 6966 and S. 3582 Safeguarding Our Hospitals' Futures Act of 2008, all provisions to require continued application of budget neutrality on a national basis in calculation of the Medicare urban hospital wage floor.

H.R. 4854 and S. 2041 False Claims Act Correction Act of 2007, all provisions to amend the False Claims Act

H.R. 800 and S. 1041 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; H.R. 1644 and S. 969 RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act.

H.R. 4854 and S. 2041 False Claims Act Correction Act of 2007, all provisions to amend the False Claims Act

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3162 Childrens Health and Medicare Protection Act of 2007, all provisions related to the Children's Health Insurance Program; S. 2499 Medicare, Medicaid, and SCHIP Extension Act of 2007, all provisions; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 3533 The Public and Teaching Hospital Preservation Act, all provisions to extend moratorium on implementation of a rule relating to the partnership under Medicaid SCHIP and finalization rule regarding GME; S. 2460 To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a rule regarding graduate medical education under Medicaid and to include a moratorium on the finalization of the outpatient Medicaid rule making similar changes; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes; H.R. 976 and S. 1893 Childrens Health Insurance Program Reauthorization Act of 2007, all provisions related to this bill; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program

S. 2672 Conrad State 30 Improvement Act, all provisions to provide incentives to physicians to practice in rural and medically underserved communities; H.R. 5924 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States, and for other purposes.

H.R. 800 and S. 1041 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; H.R. 1644 and S. 969 RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act.

Issues pertaining to coverage and other health issues; H.R. 1424 Paul Wellstone Mental Health and Addiction Equity Act of 2007, Sec. 2, 3, 5 and 6 and all provisions relating to physician-owned hospitals as well as mental health parity; S. 558 Mental Health Parity Act of 2007, all provisions related to mental health parity; H.R. 1666 Health Care Price Transparency Promotion Act of 2007, all provisions 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; S. 866 Health Promotion First Act, all provisions pertaining to health promotion reearch and dissemination; S. 1893 Children's Health Insurance Program Reauthorization Act of 2007, all provisions related to this bill; H.R. 2851 and S. 400 Michelle's Law, all provisions to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to ensure that dependent students who take a medically necessary leave of absence do not lose health insurance coverage, and for other purposes; H.R. 5544 Patients and Public Health Partnership Act of 2008, all provisions to amend the Public Health Service Act to authorize a demonstration project for integrated health systems to expand access to primary and preventive care for the medically underserved, and for other purposes; H.R. 2606 340B Program Improvement and Integrity Act of 2007, all provisions to amend section 340B of the Public Health Service Act to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 334 Healthy Americans Act, all provisions to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; H.R. 5885Health Information Technology Promotion Act of 2008, to promote a better health information system; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H.R. 5739 Physician Availability Act of 2008, to assure that the services of a non-emergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; H.R. 1174 Healthy Hospitals Act of 2007, to amend title XVIII of the Social Security Act to require public reporting of health care-associated infections data by hospitals and ambulatory surgical centers and to permit the Secretary of Health and Human Services to establish a pilot program to provide incentives to hospitals and ambulatory surgical centers to eliminate the rate of occurrence of such infections; H.R. 5942 National Trauma Center Stabilization Act of 2008, to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; H.R. 6179 Promoting Health Information Technology Act of 2008, to encourage and enhance the adoption of interoperable health information technology to improve health care quality, reduce medical errors, and increase the efficiency of care; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008' or the `PRO(TECH)T Act of 2008, to amend the Public Health Service Act to promote the adoption of health information technology, and for other purposes; H.R. 3014 Health Equity and Accountability Act of 2007, to improve the health of minority individuals, and for other purposes.

H Con Res 312 and S Con Res 70 Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013.

Issues pertaining to not-for-profit reporting practices; H.R. 2091 and S. 1963 To amend the Internal Revenue Code of 1986 to allow bonds guaranteed by the Federal home loan banks to be treated as tax exempt bonds.

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1459 all provisions to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 1741 all provisions to impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007, all provisions to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3162 Childrens Health and Medicare Protection Act of 2007, all provisions related to the Children's Health Insurance Program; S. 2499 Medicare, Medicaid, and SCHIP Extension Act of 2007, all provisions; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 3533 The Public and Teaching Hospital Preservation Act, all provisions to extend moratorium on implementation of a rule relating to the partnership under Medicaid SCHIP and finalization rule regarding GME; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; H.R. 2860 and S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes.

S. 2041 False Claims Act Correction Act of 2007, all provisions to amend the False Claims Act

H Con Res 312 and S Con Res 70 Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013.

S. 2672 Conrad State 30 Improvement Act, all provisions to provide incentives to physicians to practice in rural and medically underserved communities.

H.R. 800 and S. 1041 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; H.R. 1644 and S. 969 RESPECT Act, all provisions to amend the National Labor Relations Act to clarify the definition of `supervisor' for purposes of such Act.

H.R. 1424 Paul Wellstone Mental Health and Addiction Equity Act of 2007, all provisions relating to Sec. 2 Amendments to the Employee Retirement Income Security Act of 1974 and Sec. 3 Amendments to the Public Health Service Act relating to the group market; S. 558 Mental Health Parity Act of 2007, all provisions related to mental health parity; H.R. 1666 Health Care Price Transparency Promotion Act of 2007, all provisions 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; H.R. 800 and S. 1041 Employee Free Choice Act , all provisions to amend the National Labor Relations Act to establish an efficient system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts, and for other purposes; S. 866 Health Promotion First Act, all provisions pertaining to health promotion reearch and dissemination; S. 1893 Children's Health Insurance Program Reauthorization Act of 2007, all provisions related to this bill. Issues pertaining to coverage of the uninsured; Issues pertaining to not-for-profit reporting practices; see next page

S1002, The Hospital Fair Competion Act of 2005, provisions to amend title XVIII of the Social Security Act to make improvements in payments to hospitals under the Medicare program; HR3373 and S1405 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005, all provisions relating to extending the 50 percent compliance threshold for hospitals to qualify as inpatient rehabilitation facilities; S3678 Pandemic and All-Hazards Preparedness Act, provisions of the bill relating to the development of hospital preparedness plans; H.R.6030 Health Care Access and Rural Equity (H-CARE) Act of 2006, all provisions relating to improving health care quality in rural areas and increasing viabilty of rural providers; H.R. 6053 Health Care Price Transparency Promotion Act of 2006, all provisions related to increased price transparency of hospital information and out-of-pocket costs; S. 933 and H.R. 2350, Rural Community Hospital Assistance Act of 2005, all provisions relating to rural hospitals; H.R. 2961, Sole Community Hospital Preservation Act of 2005, Section 2 permanent hold harmless for sole community hospitals under the prospective payment system for hospital outpatient services; H.R. 1402, Paul Wellstone Mental Health Equitable Treatment Act of 2005, all provisions relating to mental health; H.R.1246, Children's Hospitals Education Equity and Research (CHEER) Act of 2005, all provisions relating to the reauthorization of the Children's Hospitals Graduate Medical Education Prog; H.R. 215 and S. 473, Allied Health Provisions Reinvestment Act of 2005, part F, all provisions relating to Allied Health; S.1440, Pulmonary and Cardiac Rehabilitation Act of 2005; SEC. 2. Coverageof items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program; H.R. 3547 and S. 1840, Safety Net Inpatient Drug Affordability Act, all provisions relating to the amendment of section 340B of the Public Health Service Act to increase the affordability of inpatient drugs for Medicaid and safety net hospitals.