ANNA SCHWAMLEIN HOWARD

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, Discussed the Confidence in Long-Term Care Insurance Act/Long-Term Insurance Reform Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed status of the CLASS Program. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act. Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program and shared stories and information related to long-term services and supports. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, Discussed the Confidence in Long-Term Care Insurance Act/Long-Term Insurance Reform Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed status of the CLASS Program. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act. Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program and shared stories and information related to long-term services and supports. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries. H. R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied on legislation to encourage state Medicaid programs to use safe, effective generic medications. S. 27, Preserve Access to Affordable Generics Act - Lobbied for this legislation preventing abuses in patent settlements between generic and brand name prescription drug companies. S. 1886/H.R. 3468, Discussed counterfeit drug penalty enhancement. Discussed prescription drugs and medical device issues. Discussed prescription drug safety, drug shortage, and medical device safety, and related user fee legislation. S. 2193, the Ensuring Safe Medical Devices for Patients Act - Discussed legislation to include devices in the post-market risk identification and analysis system for prescription drugs and to expedite the implementation of the unique device identification system for medical devices. Discussed draft legislation to address the issue of whether generic drug manufacturers have a duty to include new warnings about potentially serious side effects on their labels as they become known. The bill would accomplish this by giving generic drug makers the same ability to update their labeling as currently exists for manufacturers of brand name drugs. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries. H. R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied on legislation to encourage state Medicaid programs to use safe, effective generic medications. S. 27, Preserve Access to Affordable Generics Act - Lobbied for this legislation preventing abuses in patent settlements between generic and brand name prescription drug companies. S. 1886/H.R. 3468, Discussed counterfeit drug penalty enhancement. Discussed prescription drugs and medical device issues. Discussed prescription drug safety, drug shortage, and medical device safety, and related user fee legislation. S. 2193, the Ensuring Safe Medical Devices for Patients Act - Discussed legislation to include devices in the post-market risk identification and analysis system for prescription drugs and to expedite the implementation of the unique device identification system for medical devices. Discussed draft legislation to address the issue of whether generic drug manufacturers have a duty to include new warnings about potentially serious side effects on their labels as they become known. The bill would accomplish this by giving generic drug makers the same ability to update their labeling as currently exists for manufacturers of brand name drugs. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, Discussed the Confidence in Long-Term Care Insurance Act/Long-Term Insurance Reform Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed status of the CLASS Program. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act. Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program and shared stories and information related to long-term services and supports. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, Discussed the Confidence in Long-Term Care Insurance Act/Long-Term Insurance Reform Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed status of the CLASS Program. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act. Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program and shared stories and information related to long-term services and supports. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans. H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) H.Con.Res. 44 & Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 (no bill number as yet) - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. (no bill) Discussed need for transparency in rate reviews. (no bill) Discussed need for consumer protection in internal and external appeals for self-funded plans. (no bill) H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans. H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans. H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed opposition to Medicaid cuts. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 2267/S. 227, The Home Health Care Planning Improvement Act - Discussed the Home Health Care Planning Improvement Act that recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. S. 818/H.R. 1543, Improving Access to Medicare Coverage Act - Endorsed legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day in-patient hospital requirement for coverage of skilled nursing facility serivices under medicare. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed opposition to Medicaid cuts. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 2267/S. 227, The Home Health Care Planning Improvement Act - Discussed the Home Health Care Planning Improvement Act that recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. S. 818/H.R. 1543, Improving Access to Medicare Coverage Act - Endorsed legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day in-patient hospital requirement for coverage of skilled nursing facility serivices under medicare. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S. 1599 (no House bill), H.J. Res. 79, H.R. 2068, H.R. 2017, H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid, SSA, Older Americans Act supportive service, nutrition and family caregiver programs, LIHEAP, CLASS, and helath care delivery reform and Affordable Care Act implementation. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the debt ceiling debate. Discussed Medicare Graduate Nursing Education pilot design. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S. 1599 (no House bill), H.J. Res. 79, H.R. 2068, H.R. 2017, H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid, SSA, Older Americans Act supportive service, nutrition and family caregiver programs, LIHEAP, CLASS, and helath care delivery reform and Affordable Care Act implementation. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the debt ceiling debate. Discussed Medicare Graduate Nursing Education pilot design. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed opposition to Medicaid cuts. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 2267/S. 227, The Home Health Care Planning Improvement Act - Discussed the Home Health Care Planning Improvement Act that recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. S. 818/H.R. 1543, Improving Access to Medicare Coverage Act - Endorsed legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day in-patient hospital requirement for coverage of skilled nursing facility serivices under medicare. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S. 1599 (no House bill), H.J. Res. 79, H.R. 2068, H.R. 2017, H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid, SSA, Older Americans Act supportive service, nutrition and family caregiver programs, LIHEAP, CLASS, and helath care delivery reform and Affordable Care Act implementation. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the debt ceiling debate. Discussed Medicare Graduate Nursing Education pilot design. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of legislation to provide a hearing aid tax credit to individuals. (no bill) Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S. 1599 (no House bill), H.J. Res. 79, H.R. 2068, H.R. 2017, H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid, SSA, Older Americans Act supportive service, nutrition and family caregiver programs, LIHEAP, CLASS, and helath care delivery reform and Affordable Care Act implementation. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the debt ceiling debate. Discussed Medicare Graduate Nursing Education pilot design. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed opposition to Medicaid cuts. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 2267/S. 227, The Home Health Care Planning Improvement Act - Discussed the Home Health Care Planning Improvement Act that recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. S. 818/H.R. 1543, Improving Access to Medicare Coverage Act - Endorsed legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day in-patient hospital requirement for coverage of skilled nursing facility serivices under medicare. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed opposition to Medicaid cuts. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 2267/S. 227, The Home Health Care Planning Improvement Act - Discussed the Home Health Care Planning Improvement Act that recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. S. 818/H.R. 1543, Improving Access to Medicare Coverage Act - Endorsed legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day in-patient hospital requirement for coverage of skilled nursing facility serivices under medicare. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs.

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94, and 95 - Lobbied for funding for agencies and programs within the jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), Financial Services and General Government Appropriations (H.R. 2434/S. 1573), Agriculture Appropriations (H.R. 2112, S. 1573), Transportation-HUD (S.1596), Commerce-Justice-Science (H.R. 2596, S. 1572). H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries.

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. H. R. 2112, Agriculture, Rural Development, FDA and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for Supplemental Food Assistance Program (SNAP) and Commodity Supplemental Food Program (CSFP). Sent letter in support of Richardson floor amendment to H.R. 2112 (H. Amdt. 434) to increase CSFP funding. H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the debt ceiling debate.

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94, and 95 - Lobbied for funding for agencies and programs within the jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), Financial Services and General Government Appropriations (H.R. 2434/S. 1573), Agriculture Appropriations (H.R. 2112, S. 1573), Transportation-HUD (S.1596), Commerce-Justice-Science (H.R. 2596, S. 1572). H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries.

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. H. R. 2112, Agriculture, Rural Development, FDA and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for Supplemental Food Assistance Program (SNAP) and Commodity Supplemental Food Program (CSFP). Sent letter in support of Richardson floor amendment to H.R. 2112 (H. Amdt. 434) to increase CSFP funding. H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the debt ceiling debate.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94, and 95 - Lobbied for funding for agencies and programs within the jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), Financial Services and General Government Appropriations (H.R. 2434/S. 1573), Agriculture Appropriations (H.R. 2112, S. 1573), Transportation-HUD (S.1596), Commerce-Justice-Science (H.R. 2596, S. 1572). H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans. H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans. H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid.

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94, and 95 - Lobbied for funding for agencies and programs within the jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), Financial Services and General Government Appropriations (H.R. 2434/S. 1573), Agriculture Appropriations (H.R. 2112, S. 1573), Transportation-HUD (S.1596), Commerce-Justice-Science (H.R. 2596, S. 1572). H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

H.J. Res. 44, H.J. 48, H.R. 2112, H.J. Res. 79, H.R. 2608, H.R. 2017, Continuing Appropriations Amendments, FY 2011 - Lobbied for funding for FDA Office of Generic Drugs and nutrition assistance. Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. (no bill) Discussed need for transparency in rate reviews. (no bill) Discussed need for consumer protection in internal and external appeals for self-funded plans. (no bill) H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res.79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Agriculture Appropriations bill ( H.R. 2112, S. 1573), including funding for the FDA Office of Generic Drugs. Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries. H. R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied on legislation to encourage state Medicaid programs to use safe, effective generic medications. S. 27, Preserve Access to Affordable Generics Act - Lobbied for this legislation preventing abuses in patent settlements between generic and brand name prescription drug companies. Discussed counterfeit drug penalty enhancement (S. 1886/H.R.3468).

H.J. Res. 44, H.J. 48, H.R. 2112, H.J. Res. 79, H.R. 2608, H.R. 2017, Continuing Appropriations Amendments, FY 2011 - Lobbied for funding for FDA Office of Generic Drugs and nutrition assistance. Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. H. R. 2112, Agriculture, Rural Development, FDA and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for Supplemental Food Assistance Program (SNAP) and Commodity Supplemental Food Program (CSFP). Sent letter in support of Richardson floor amendment to H.R. 2112 (H. Amdt. 434) to increase CSFP funding. H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the debt ceiling debate.

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94, and 95 - Lobbied for funding for agencies and programs within the jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), Financial Services and General Government Appropriations (H.R. 2434/S. 1573), Agriculture Appropriations (H.R. 2112, S. 1573), Transportation-HUD (S.1596), Commerce-Justice-Science (H.R. 2596, S. 1572). H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94, and 95 - Lobbied for funding for agencies and programs within the jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), Financial Services and General Government Appropriations (H.R. 2434/S. 1573), Agriculture Appropriations (H.R. 2112, S. 1573), Transportation-HUD (S.1596), Commerce-Justice-Science (H.R. 2596, S. 1572). H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. (no bill) Discussed need for transparency in rate reviews. (no bill) Discussed need for consumer protection in internal and external appeals for self-funded plans. (no bill) H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans. H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans. H. R. 1213, To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges - Sent letter in opposition to HR 1213 which would repeal the mandatory funding provided to states under the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared Savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. (no bill) Lobbied in support of Medicare physician payment reform. (no bill) Discussed legislation to make prescription drugs more affordable to older Americans. (no bill) S. 1599/H.R. 3070, H.J. Res. 79, H.R. 2608, H.R. 2017, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees re funding for SSA Administration, Older americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res.79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Agriculture Appropriations bill ( H.R. 2112, S. 1573), including funding for the FDA Office of Generic Drugs. Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries. H. R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied on legislation to encourage state Medicaid programs to use safe, effective generic medications. S. 27, Preserve Access to Affordable Generics Act - Lobbied for this legislation preventing abuses in patent settlements between generic and brand name prescription drug companies. Discussed counterfeit drug penalty enhancement (S. 1886/H.R.3468).

Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res.79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Agriculture Appropriations bill ( H.R. 2112, S. 1573), including funding for the FDA Office of Generic Drugs. Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries. H. R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied on legislation to encourage state Medicaid programs to use safe, effective generic medications. S. 27, Preserve Access to Affordable Generics Act - Lobbied for this legislation preventing abuses in patent settlements between generic and brand name prescription drug companies. Discussed counterfeit drug penalty enhancement (S. 1886/H.R.3468).

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Worked with Coalition to Influence Select Joint Budget Committee priorities. (no bill) Discussed debt ceiling and possible impact on Medicare, Medicaid, and Social Security. (no bill) S. 163, Full Faith and Credit Act - Discussed AARP position on legislation and second degree amendment to the legislation. S.245, CAP Act of 2011 - Discussed our concerns and opposition to the legislation. H.J. Res. 1/S.J. Res. 4 - Proposing a balanced budget to the Constitution - Discussed legislation. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94, and 95 - Lobbied for funding for agencies and programs within the jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), Financial Services and General Government Appropriations (H.R. 2434/S. 1573), Agriculture Appropriations (H.R. 2112, S. 1573), Transportation-HUD (S.1596), Commerce-Justice-Science (H.R. 2596, S. 1572). H.R. 2434/S. 1573 - Financial Services & General Appropriations bill for FY 2012 - Lobbied against language included in Subcommittee mark restricting funding of Consumer Finance Protection Bureau to $200 million and making new entity subject to appropriations. Sent letter to House Appropriations Committee leadership in opposition to cap and other changes to Dodd-Frank. S. 1599, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY 2012 - Lobbied for funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. H.Con. Res.34, H.R. 2560/S. 627/H.R. 2693/S. 365, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021 - Lobbied against House Concurrent Resolution on the Budget for Fiscal Year 2012. S.Con. Res. 18, President's FY 2012 Budget Resolution - A concurrent resolution setting forth the President's budget request for the Unites States Government for fiscal year 2012, and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S.Con.Res. 21, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2021. Lobbied against the budget proposal that would result in cuts to Medicare, Medicaid and Social Security. S. Con.Res. 20, A concurrent resolution setting forth the Congressional budget for the United States Government for fiscal year 2012 and setting forth the appropriate budgetary levels for fiscal years 2013 through 2016. Lobbied against budget proposal that would result in cuts to Medicare, Medicaid and Social Security. PL. 111-148, Discussed continued funding for Patient Protection and Affordable Care Act provisions. S. 365, Budget Control Act - Lobbied Congress against cuts to Social Security, Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res.79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Agriculture Appropriations bill ( H.R. 2112, S. 1573), including funding for the FDA Office of Generic Drugs. Discussed legislative intent with respect to Biologic drugs and exclusivity period.(no bill) Discussed importance of potential savings both to consumers and to the federal government of granting Secretarial Negotiating Authority to Secretary of HHS on Medicare Part D. (no bill) Discussed need for greater consumer safety protections both in OTC and prescription drugs. (no bill) Discussed need to end industry tactics like Pay for Delay which inappropriately extends patents with effect of keeping prices high for consumers and government. (no bill) Discussed need for doctors to get unbiased information on prescription pharmaceuticals through programs like academic detailing. (no bill) Discussed possible savings and better health care outcomes that could result from Medication Therapy Management. (no bill) Pub. Law 111-148 and 111-152 - Discussed implementation of health care legislation to reform the health care system to provide quality healthcare, expand access to long-term services and supports, and reduced prescription drug costs. Discussed greater affordability of generic versions of both generic and biologic drugs. S. 319, Pharmaceutical Market Access and Drug Safety Act of 2011 - Discussed legislation that establishes a framework for the safe, legal importation of lower-priced prescription drugs from abroad. S. 1206, Medicare Drug Savings Act of 2011 - Discussed rebates in Medicare Part D as a cost savings measure in Medicare that does not harm beneficiaries. H. R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied on legislation to encourage state Medicaid programs to use safe, effective generic medications. S. 27, Preserve Access to Affordable Generics Act - Lobbied for this legislation preventing abuses in patent settlements between generic and brand name prescription drug companies. Discussed counterfeit drug penalty enhancement (S. 1886/H.R.3468).

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of legislation to provide a hearing aid tax credit to individuals. (no bill) Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies.

Pub. Law 111-148 and 111-152, Patient Protection and Affordability Care Act - Discussed implementation of certain provisions related to affordable quality health care and expand access to long-term services and supports. H.R. 63, Long Term Care Insurance Reform Act of 2011 - Lobbied for legislation that improves consumer protections and provides better information regarding private long-term care insurance policies. S. 159, The Confidence in Long-Term Care Insurance Act of 2011- Discussed legislation that would improve consumer protections and provide better information regarding private Long-Term care insurance policies. Discussed employer sponsored wellness programs. Discussed need for transparency in rate reviews. Discussed need for consumer protection in internal and external appeals for self-funded plans.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.1256 Home and Community Balanced Incentives Act - Discussed implementation of certain enacted provisions. Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. S. 227, Home Health Planning Improvement Act of 2011 - Lobbied for Nurse Practitioners, Clinical Nurse Specialists, and Physician Assistants being able to order Medicare funded home health care. Improving Access to Medicare Coverage Act - Discussed draft legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare.(no bill) Discussed transitional care demonstration program. Discussed how to preserve Medicaid services despite budgetary pressures at both state and federal levels. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of legislation to eliminate the 190-day lifetime limit on in-patient psychiatric hospital services. H.J.Res. 44, H.J. Res. 48, Continuing Appropriations Amendments, FY 2011 - Lobbied for funding for various federal programs serving Older Americans, most notably SSA Administrative expenses, LIHEAP, aging services, HECM reverse mortgage subsidy and Section 202, Housing for the Elderly. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act, including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed opposition to Medicaid cuts. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 2267/S. 227, The Home Health Care Planning Improvement Act - Discussed the Home Health Care Planning Improvement Act that recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. S. 818/H.R. 1543, Improving Access to Medicare Coverage Act - Endorsed legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day in-patient hospital requirement for coverage of skilled nursing facility serivices under medicare. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S. 1599 (no House bill), H.J. Res. 79, H.R. 2068, H.R. 2017, H.J.Res. 44, Labor-Health & Human Services, Education and Related Agencies appropriations bill for FY 2012 - Lobbied for funding for LIHEAP. Lobbied for funding for Medicaid, SSA, Older Americans Act supportive service, nutrition and family caregiver programs, LIHEAP, CLASS, and helath care delivery reform and Affordable Care Act implementation. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the debt ceiling debate. Discussed Medicare Graduate Nursing Education pilot design. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed Medicare GNE demonstration design problems. Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of legislation to provide a hearing aid tax credit to individuals. (no bill) Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed medical loss ratio. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.1256 Home and Community Balanced Incentives Act - Discussed implementation of certain enacted provisions. Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. S. 227, Home Health Planning Improvement Act of 2011 - Lobbied for Nurse Practitioners, Clinical Nurse Specialists, and Physician Assistants being able to order Medicare funded home health care. Improving Access to Medicare Coverage Act - Discussed draft legislation to count a period of observation status in a hospital exceeding 24 hours toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare.(no bill) Discussed transitional care demonstration program. Discussed how to preserve Medicaid services despite budgetary pressures at both state and federal levels. (no bill) Discussed how to implement Medicaid provisions of Affordable Care Act. Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of legislation to eliminate the 190-day lifetime limit on in-patient psychiatric hospital services. H.J.Res. 44, H.J. Res. 48, Continuing Appropriations Amendments, FY 2011 - Lobbied for funding for various federal programs serving Older Americans, most notably SSA Administrative expenses, LIHEAP, aging services, HECM reverse mortgage subsidy and Section 202, Housing for the Elderly. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act, including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. H.R. 978 - Lobbied in support of legislation to preclude the use of Social Security numbers on government issued identification cards. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill)

S. 3686, Labor, HHS, Education and related agencies appropriations bill for FY 2011 - Lobbied for funding for SSA, Older Americans Act programs. Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act), among other items, LIHEAP and weatherization. (no bill) H.R. 4899, Supplemental Appropriations Act - Lobbied for inclusion of emergency food assistance, SSA and CMS program integrity activity and other non-defense discretionary funding levels for FY 2011. Transportation HUD Appropriations (no bill) - Lobbied in support of funding for HUD Section 202 senior housing program. H.R. 3081, H.R. 3082, H.J. Res. 101, H.J. Res. 105, Continuing Appropriations Act, FY 2011 - Lobbied for funding for various federal programs serving Older Americans, most notably SSA Administrative expenses, LIHEAP, aging services, HECM reverse mortgage subsidy and Section 202, Housing for the Elderly.

H.R.3590, Patient Protection and Affordable Care Act - Lobbied in support of and on implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long-term services and supports. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.1569/H.R.3185, Medicare Graduate Nursing Education Act - Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population. S. 623/HR 1558, Pre-existing Condition Patient Protection Act of 2009 - Lobbied in support of bill that would prohibit insurers from denying health insurance or delaying coverage for people with pre-existing conditions. H.R. 2778, Health Equity and Accountability through Research Act of 2009 - Lobbied in support of bill that would address racial and ethnic disparities in care. S. 979/HR 2360, Small Business Health Options Programs Act - Lobbied in support of bill that would establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable and accessible. S.1213, Patient-Centered Outcomes Research Act - Lobbied in support of bill that would create a public-private partnership to conduct and disseminate comparative effectiveness research. S. 726/H.R. 1427, Promoting Innovation and Access to Life Saving Medicines - Discussed legislation which would create a pathway for approval of safe, effective biosimilar and generic biologic drugs. H.R. 3090, Health Equity and Accountability Act - Discussed need to end racial and ethnic disparities in care. S. 3686, Labor, HHS, Education and Related Agencies Appropriations Act FY 2011 - Lobbied for funding for healthcare services, research and training involving NIH, AHRQ, CMS, HRSA, HHS and AOA. H.R. 3082, H.R. 3081, H.J. Res.101, H.J. Res. 105, Continuing Appropriations and Surface Transportation Extensions Act, 2011 - Lobbied for funding for various federal programs serving Older Americans, most notably SSA Administrative expenses, LIHEAP, aging services, HECM reverse mortgage subsidy and Section 202, Housing for the Elderly. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care law which makes improvements such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act and implementation of some provisions. H.R. 5364, Special Care Dentistry Act - Discussed bill that would require states to provide oral health coverage for aged, blind,or disabled individuals through a separate state adult dental program, with 100% federal match. H.R. 4213, American Workers, State and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR. H.R. 3081, Continuing Resolution, FY 2011 - Lobbied for funding for SSA, various health care, employment, aging services and nutrition programs. H.R. 4224, Together We Care Act - Bill creates a three-year pilot program to train public housing residents to provide covered home-based health services. H.R. 5853, Fiscal Responsibility and Retirement Security Act - Bill requires review and approval by law prior to collection of premiums under the CLASS program, to require notice to individuals prior to enrollment, and to require termination of the program in the event of actuarial unsoundness, and for other purposes. S. 2814, Home Health Care Planning Improvement Act of 2010 - Bill recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare. H.R. 4993, Home Health Care Planning Improvement Act of 2010 - Bill recognizes and authorizes nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants as eligible health care professionals who can order home health services under Medicare.

S.525/H.R.1298/S.1232, Pharmaceutical Market Access and Drug Safety Act of 2009 - Discussed legislation which would create a system of safe importation of prescription drugs from abroad. S.726/H.R.1427, Promoting Innovation and Access to Life-Saving Medicine Act - Discussed legislation which would create a pathway for the approval of safe, effective biosimilar and generic biologic drugs. H.R.1706, Protecting Consumer Access to Generic Drugs Act of 2009 - Discussed legislation that would prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market, and for other purposes. S. 369, Preserve Access to Affordable Generics Act - Discussed legislation that would prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market,and for other purposes. S.515/H.R.1260/S.610, Patent Reform Act of 2009 - Discussed legislation that would amend federal patent law to rewrite provisions concerning the conditions for patentability. Specifically, AARP weighed in on the inequitable conduct provisions of the legislation. S. 301, Physician Payments Sunshine Act of 2009 - Discussed legislation that would provide for disclosure of gifts given by pharmaceutical and device manufacturers to physicians. S.1315, Federal Food, Drug and Cosmetic Act Amendment/H.R.3777 Drug Price Competition Act - Lobbied to expand the definition of "first applicant" under such Act to allow a generic drug manufacturer that is currently considered an applicant subsequent to a brand-name manufacturer's 180-day exclusivity period to qualify as a first applicant for purposes of filing an abbreviated application for a new drug. Requires such applicant ot submit a substantially complete application that contains and lawfully maintains a certification for such drug. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and implementation of health care legislation to reform the health care system to provide quality health care and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of and implementation of health care law which makes improvements, such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act. S. 3606, Agriculture, Rural Development, FDA and related agencies Appropriations Act, FY 2011 - Lobbied for increased funding for the FDA Office of Generic Drugs to reduction of application backlog. H.R. 3081, H.R. 3082, H.J.Res. 105, H.J.Res.101, Continuing Resolution, FY 2011 - Lobbied for funding for FDA Office of Generic Drugs and nutrition assistance. S.3690, the Drug Safety and Accountability Act of 2010 - Requires drug manufacturers to implement quality management plans and document the manufacturing supply chain to ensure the quality and safety of drugs. The bill also would expand FDA authority to recall unsafe drugs, uncluding over the counter drugs, and offers protection to whistle blowers. H.R.5809,would amend the Controlled Substances Act to provide for the take back and safe disposal of controlled substances. The bill provides for an educational effort about proper drug disposal, an EPA report on the same and a GAO report on the effectiveness of disposal programs.

S. 3686, Labor, HHS, Education and related agencies appropriations bill for FY 2011 - Lobbied for funding for SSA, Older Americans Act programs. Lifespan Respite Care Act, Nursing Education/Workforce Development, National Corporation for Community Service (Kennedy Serve America Act), among other items, LIHEAP and weatherization. (no bill) H.R. 4899, Supplemental Appropriations Act - Lobbied for inclusion of emergency food assistance, SSA and CMS program integrity activity and other non-defense discretionary funding levels for FY 2011. Transportation HUD Appropriations (no bill) - Lobbied in support of funding for HUD Section 202 senior housing program. H.R. 3081, H.R. 3082, H.J. Res. 101, H.J. Res. 105, Continuing Appropriations Act, FY 2011 - Lobbied for funding for various federal programs serving Older Americans, most notably SSA Administrative expenses, LIHEAP, aging services, HECM reverse mortgage subsidy and Section 202, Housing for the Elderly.

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Discussed implementation of healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed implementation of certain enacted provisions. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and on new implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of and on implementation of health care law to make improvements in the Patient Protection and Affordable Care Act and implementation of certain provisions. H.R. 4993/S. 2814, Home Health Planning Improvement Act of 2010 - Wrote letters in support of Nurse Practitioners, Clinical Nurse Specialists, and Physician Assistants being able to order Medicare funded home health care. Extension of enhanced FMAP (no bill number) H. R. 3962/P.L. 111-192, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Which among other things, postpones the reduction of Medicare reimbursements for physician services until November 30, 2010. H.R. 6130, Strengthening Medicare Anti-Fraud Measures Act - Discussed medicare fraud. H.R. 5044/S. 3632, Medicare Fraud Enforcement and Prevention Act - Discussed medicare fraud. H.R. 5546, no official title, anti-fraud measure -Discussed medicare fraud. H.R. 5950, Improving Access to Medicare Coverage Act - To count a periof of observation status in a hospital exceeding 24 hours toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. H.R. 2773/S. 1295, Medicare Transitional Care Act and S. Amdt. 3273, Protection and Affordable Care Act - To cover transitional care services to improve the quality and care under the Medicare Program. S. 3632, The Medicare and Medicaid Fraud Enforcement and Prevention Act of 2010 - Fraud bill would seek to curtail wasted fraud and abuse in the Medicare and Healthcare Programs. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. H.R. 4213 American Workers, State, and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR. S. 3686, Labor, HHS, Education and related agencies Appropriations Act, FY 2011 - Lobbied for FMAP fix and related health care programs. S. 2814/H.R. 4993, Home Health Care Planning Improvements Act of 2010 - Legislation would allow advanced practice nurses and physician assistants to order medicare supported home health care. Discussed Durable Medical Equipment bidding. (no bill) H.R.5712, Physician Payment and Therapy Relief Act of 2010 - Lobbied in support of legislation that would provide a one-month extension of the existing physician payment update. H.R.4994, Medicare and Medicaid Extenders Act of 2010 - Lobbied in support of legislation that would provide a one year extension of the physician payment update. H.R. 3081, Continuing Resolution FY 2011, H.J.Res. 105, making further continuing appropriations for fiscal year 2011, and H.J.Res. 101 making further continuing appropriations for fiscal year 2011 - Lobbied for FMA fix inclusion in appropriations legislation.

S.525/H.R.1298/S.1232, Pharmaceutical Market Access and Drug Safety Act of 2009 - Discussed legislation which would create a system of safe importation of prescription drugs from abroad. S.726/H.R.1427, Promoting Innovation and Access to Life-Saving Medicine Act - Discussed legislation which would create a pathway for the approval of safe, effective biosimilar and generic biologic drugs. H.R.1706, Protecting Consumer Access to Generic Drugs Act of 2009 - Discussed legislation that would prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market, and for other purposes. S. 369, Preserve Access to Affordable Generics Act - Discussed legislation that would prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market,and for other purposes. S.515/H.R.1260/S.610, Patent Reform Act of 2009 - Discussed legislation that would amend federal patent law to rewrite provisions concerning the conditions for patentability. Specifically, AARP weighed in on the inequitable conduct provisions of the legislation. S. 301, Physician Payments Sunshine Act of 2009 - Discussed legislation that would provide for disclosure of gifts given by pharmaceutical and device manufacturers to physicians. S.1315, Federal Food, Drug and Cosmetic Act Amendment/H.R.3777 Drug Price Competition Act - Lobbied to expand the definition of "first applicant" under such Act to allow a generic drug manufacturer that is currently considered an applicant subsequent to a brand-name manufacturer's 180-day exclusivity period to qualify as a first applicant for purposes of filing an abbreviated application for a new drug. Requires such applicant ot submit a substantially complete application that contains and lawfully maintains a certification for such drug. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and implementation of health care legislation to reform the health care system to provide quality health care and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of and implementation of health care law which makes improvements, such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act. S. 3606, Agriculture, Rural Development, FDA and related agencies Appropriations Act, FY 2011 - Lobbied for increased funding for the FDA Office of Generic Drugs to reduction of application backlog. H.R. 3081, H.R. 3082, H.J.Res. 105, H.J.Res.101, Continuing Resolution, FY 2011 - Lobbied for funding for FDA Office of Generic Drugs and nutrition assistance. S.3690, the Drug Safety and Accountability Act of 2010 - Requires drug manufacturers to implement quality management plans and document the manufacturing supply chain to ensure the quality and safety of drugs. The bill also would expand FDA authority to recall unsafe drugs, uncluding over the counter drugs, and offers protection to whistle blowers. H.R.5809,would amend the Controlled Substances Act to provide for the take back and safe disposal of controlled substances. The bill provides for an educational effort about proper drug disposal, an EPA report on the same and a GAO report on the effectiveness of disposal programs.

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Discussed implementation of healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed implementation of certain enacted provisions. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and on new implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of and on implementation of health care law to make improvements in the Patient Protection and Affordable Care Act and implementation of certain provisions. H.R. 4993/S. 2814, Home Health Planning Improvement Act of 2010 - Wrote letters in support of Nurse Practitioners, Clinical Nurse Specialists, and Physician Assistants being able to order Medicare funded home health care. Extension of enhanced FMAP (no bill number) H. R. 3962/P.L. 111-192, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Which among other things, postpones the reduction of Medicare reimbursements for physician services until November 30, 2010. H.R. 6130, Strengthening Medicare Anti-Fraud Measures Act - Discussed medicare fraud. H.R. 5044/S. 3632, Medicare Fraud Enforcement and Prevention Act - Discussed medicare fraud. H.R. 5546, no official title, anti-fraud measure -Discussed medicare fraud. H.R. 5950, Improving Access to Medicare Coverage Act - To count a periof of observation status in a hospital exceeding 24 hours toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. H.R. 2773/S. 1295, Medicare Transitional Care Act and S. Amdt. 3273, Protection and Affordable Care Act - To cover transitional care services to improve the quality and care under the Medicare Program. S. 3632, The Medicare and Medicaid Fraud Enforcement and Prevention Act of 2010 - Fraud bill would seek to curtail wasted fraud and abuse in the Medicare and Healthcare Programs. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. H.R. 4213 American Workers, State, and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR. S. 3686, Labor, HHS, Education and related agencies Appropriations Act, FY 2011 - Lobbied for FMAP fix and related health care programs. S. 2814/H.R. 4993, Home Health Care Planning Improvements Act of 2010 - Legislation would allow advanced practice nurses and physician assistants to order medicare supported home health care. Discussed Durable Medical Equipment bidding. (no bill) H.R.5712, Physician Payment and Therapy Relief Act of 2010 - Lobbied in support of legislation that would provide a one-month extension of the existing physician payment update. H.R.4994, Medicare and Medicaid Extenders Act of 2010 - Lobbied in support of legislation that would provide a one year extension of the physician payment update. H.R. 3081, Continuing Resolution FY 2011, H.J.Res. 105, making further continuing appropriations for fiscal year 2011, and H.J.Res. 101 making further continuing appropriations for fiscal year 2011 - Lobbied for FMA fix inclusion in appropriations legislation.

S.525/H.R.1298/S.1232, Pharmaceutical Market Access and Drug Safety Act of 2009 - Discussed legislation which would create a system of safe importation of prescription drugs from abroad. S.726/H.R.1427, Promoting Innovation and Access to Life-Saving Medicine Act - Discussed legislation which would create a pathway for the approval of safe, effective biosimilar and generic biologic drugs. H.R.1706, Protecting Consumer Access to Generic Drugs Act of 2009 - Discussed legislation that would prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market, and for other purposes. S. 369, Preserve Access to Affordable Generics Act - Discussed legislation that would prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market,and for other purposes. S.515/H.R.1260/S.610, Patent Reform Act of 2009 - Discussed legislation that would amend federal patent law to rewrite provisions concerning the conditions for patentability. Specifically, AARP weighed in on the inequitable conduct provisions of the legislation. S. 301, Physician Payments Sunshine Act of 2009 - Discussed legislation that would provide for disclosure of gifts given by pharmaceutical and device manufacturers to physicians. S.1315, Federal Food, Drug and Cosmetic Act Amendment/H.R.3777 Drug Price Competition Act - Lobbied to expand the definition of "first applicant" under such Act to allow a generic drug manufacturer that is currently considered an applicant subsequent to a brand-name manufacturer's 180-day exclusivity period to qualify as a first applicant for purposes of filing an abbreviated application for a new drug. Requires such applicant ot submit a substantially complete application that contains and lawfully maintains a certification for such drug. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and implementation of health care legislation to reform the health care system to provide quality health care and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of and implementation of health care law which makes improvements, such as closing the Part D coverage gap, in the Patient Protection and Affordable Care Act. S. 3606, Agriculture, Rural Development, FDA and related agencies Appropriations Act, FY 2011 - Lobbied for increased funding for the FDA Office of Generic Drugs to reduction of application backlog. H.R. 3081, H.R. 3082, H.J.Res. 105, H.J.Res.101, Continuing Resolution, FY 2011 - Lobbied for funding for FDA Office of Generic Drugs and nutrition assistance. S.3690, the Drug Safety and Accountability Act of 2010 - Requires drug manufacturers to implement quality management plans and document the manufacturing supply chain to ensure the quality and safety of drugs. The bill also would expand FDA authority to recall unsafe drugs, uncluding over the counter drugs, and offers protection to whistle blowers. H.R.5809,would amend the Controlled Substances Act to provide for the take back and safe disposal of controlled substances. The bill provides for an educational effort about proper drug disposal, an EPA report on the same and a GAO report on the effectiveness of disposal programs.