BRENT EVANS

See Next Page for Narrative.Support for H.R. 1250, and S. 1012, the Medicare Audit Improvement Act of 2013; Promote the Medicare Audit Improvement Act of 2013, review the amount by congressional district of enacted reductions in hospital Medicare and Medicaid disproportionate share hospitals payments for 2013-2019 and the implications for cost-shifting of the Missouri General Assemblys decision not to expand Medicaid eligibility as authorized by the Patient Protection and Affordable Care Act of 2010; CMS proposed regulations to implement the Medicare DSH reductions authorized by the Patient Protection and Affordable Care Act of 2010; Efforts to repeal or revamp section 3141 of the Patient Protection and Affordable Care of 2010 (S. 183, H.R. 2053); CMS standards for awarding vendor contracts to Medicare Recovery Audit Contractors; Medicare hospital payment restrictions based on preventable hospital readmissions; HR 1787, The Rural Hospital Access Act, all provisions; Congressional request re: Missouri Hospital Associations stance on the Patient Protection and Affordable Care Act of 2010 at the time of its enactment; Congressional inquiry re: the amount of Medicare bad debt incurred by Missouris hospitals and the effect of the Obama Administrations proposal in its proposed FFY 2014 budget to restrict Medicares payments to partly offset Medicare bad debt costs; Oppose a proposal included in the Obama Administrations proposed budget for FFY 2014 that would preclude designation as a critical access hospital for any hospital facility located within 10 miles of another hospital; Congressional request regarding federally qualified health centers in Missouri; Request for CMS to update its list of skilled nursing facilities to include swing-bed providers.

See Next Page for Narrative.Support for H.R. 1250, and S. 1012, the Medicare Audit Improvement Act of 2013; Promote the Medicare Audit Improvement Act of 2013, review the amount by congressional district of enacted reductions in hospital Medicare and Medicaid disproportionate share hospitals payments for 2013-2019 and the implications for cost-shifting of the Missouri General Assemblys decision not to expand Medicaid eligibility as authorized by the Patient Protection and Affordable Care Act of 2010; CMS proposed regulations to implement the Medicare DSH reductions authorized by the Patient Protection and Affordable Care Act of 2010; Efforts to repeal or revamp section 3141 of the Patient Protection and Affordable Care of 2010 (S. 183, H.R. 2053); CMS standards for awarding vendor contracts to Medicare Recovery Audit Contractors; Medicare hospital payment restrictions based on preventable hospital readmissions; HR 1787, The Rural Hospital Access Act, all provisions; Congressional request re: Missouri Hospital Associations stance on the Patient Protection and Affordable Care Act of 2010 at the time of its enactment; Congressional inquiry re: the amount of Medicare bad debt incurred by Missouris hospitals and the effect of the Obama Administrations proposal in its proposed FFY 2014 budget to restrict Medicares payments to partly offset Medicare bad debt costs; Oppose a proposal included in the Obama Administrations proposed budget for FFY 2014 that would preclude designation as a critical access hospital for any hospital facility located within 10 miles of another hospital; Congressional request regarding federally qualified health centers in Missouri; Request for CMS to update its list of skilled nursing facilities to include swing-bed providers.

See Next Page for Narrative.Promote a resolution between The Higher Learning Commissions accreditation standards and Medicare nursing school payment requirements; The criteria used to designate critical access hospitals under the Medicare program; Extension of temporary restrictions of the authority of Recovery Audit Contractors and Medicare Audit Contractors to conduct reviews of Part A inpatient admissions based on the two midnight standard; Potential implementation of recommendations of the DHHS Office of Inspector General regarding changes to the designation of critical access hospitals; H.R.1250/S. 1012, The Medicare Audit Improvement Act of 2013, all sections; CMS' continuation of quarterly meetings with representatives of state hospital associations; Medicaid disproportionate share hospital payments to Missouri hospitals; Support for the Senate Finance Committee amendment (Enzi) adding S. 183 (Hospital Fairness Act) to S. Con. Res. 8 (Budget Resolution) and opposed Senate Finance Committee Amendment 0651 to S. Con. Res. 8 (Menendez); The requirements of the federal EMTALA law on hospital emergency departments; Support for The Hospital Payment Fairness Act (S. 183/H.R. 2053);

See Next Page for Narrative.CMS design and implementation of Missouris federally-facilitated health insurance exchange (Marketplace); Preventing and Reducing Improper Medicare and Medicaid Expenditures act of 2013; "Dear Colleague" letter by Congresswoman Jenkins (R-KS) regarding Medicare payments for inpatient rehabilitation services Regulatory standards to create a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health plans; EHR incentives for Rural Health Clinics regarding H.R. 986, the Rural Clinic Fairness Act; Hospital financial performance metrics and trends; Medicare sustainable growth rate formula for determining payments for physician services under the Medicare program; Promote H.R. 1250 and S. 1012, regarding accountability standards for Medicare Recovery Audit Contractors and other program integrity initiatives; Ooppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Promote S. 183 and H.R. 2053, concerning repeal of section 3141 of the Patient Protection and Affordable Care Act of 2010; Oppose legislative proposals to restrict states ability to use provider taxes to fund their Medicaid programs; Promote reauthorization for an additional year of the Medicare Dependent Hospital program; Oppose legislative efforts to limit the scope of the 340B program, which authorizes price discounts on the purchase of pharmaceuticals by designated safety net providers and make them aware of CMS regulatory actions regarding a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health; Responded to a request from a Missouri congressional office to clarify the number of critical access hospitals in Missouri; Letter to oppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Missouri Hospital Association reports entitled A View of Two Missouris How Insurance Coverage Affects the Health and Productivity of Its People

See Next Page for Narrative.Support for H.R. 1250, and S. 1012, the Medicare Audit Improvement Act of 2013; Promote the Medicare Audit Improvement Act of 2013, review the amount by congressional district of enacted reductions in hospital Medicare and Medicaid disproportionate share hospitals payments for 2013-2019 and the implications for cost-shifting of the Missouri General Assemblys decision not to expand Medicaid eligibility as authorized by the Patient Protection and Affordable Care Act of 2010; CMS proposed regulations to implement the Medicare DSH reductions authorized by the Patient Protection and Affordable Care Act of 2010; Efforts to repeal or revamp section 3141 of the Patient Protection and Affordable Care of 2010 (S. 183, H.R. 2053); CMS standards for awarding vendor contracts to Medicare Recovery Audit Contractors; Medicare hospital payment restrictions based on preventable hospital readmissions; HR 1787, The Rural Hospital Access Act, all provisions; Congressional request re: Missouri Hospital Associations stance on the Patient Protection and Affordable Care Act of 2010 at the time of its enactment; Congressional inquiry re: the amount of Medicare bad debt incurred by Missouris hospitals and the effect of the Obama Administrations proposal in its proposed FFY 2014 budget to restrict Medicares payments to partly offset Medicare bad debt costs; Oppose a proposal included in the Obama Administrations proposed budget for FFY 2014 that would preclude designation as a critical access hospital for any hospital facility located within 10 miles of another hospital; Congressional request regarding federally qualified health centers in Missouri; Request for CMS to update its list of skilled nursing facilities to include swing-bed providers.

See Next Page for Narrative.Promote a resolution between The Higher Learning Commissions accreditation standards and Medicare nursing school payment requirements; The criteria used to designate critical access hospitals under the Medicare program; Extension of temporary restrictions of the authority of Recovery Audit Contractors and Medicare Audit Contractors to conduct reviews of Part A inpatient admissions based on the two midnight standard; Potential implementation of recommendations of the DHHS Office of Inspector General regarding changes to the designation of critical access hospitals; H.R.1250/S. 1012, The Medicare Audit Improvement Act of 2013, all sections; CMS' continuation of quarterly meetings with representatives of state hospital associations; Medicaid disproportionate share hospital payments to Missouri hospitals; Support for the Senate Finance Committee amendment (Enzi) adding S. 183 (Hospital Fairness Act) to S. Con. Res. 8 (Budget Resolution) and opposed Senate Finance Committee Amendment 0651 to S. Con. Res. 8 (Menendez); The requirements of the federal EMTALA law on hospital emergency departments; Support for The Hospital Payment Fairness Act (S. 183/H.R. 2053);

See Next Page for Narrative.CMS design and implementation of Missouris federally-facilitated health insurance exchange (Marketplace); Preventing and Reducing Improper Medicare and Medicaid Expenditures act of 2013; "Dear Colleague" letter by Congresswoman Jenkins (R-KS) regarding Medicare payments for inpatient rehabilitation services Regulatory standards to create a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health plans; EHR incentives for Rural Health Clinics regarding H.R. 986, the Rural Clinic Fairness Act; Hospital financial performance metrics and trends; Medicare sustainable growth rate formula for determining payments for physician services under the Medicare program; Promote H.R. 1250 and S. 1012, regarding accountability standards for Medicare Recovery Audit Contractors and other program integrity initiatives; Ooppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Promote S. 183 and H.R. 2053, concerning repeal of section 3141 of the Patient Protection and Affordable Care Act of 2010; Oppose legislative proposals to restrict states ability to use provider taxes to fund their Medicaid programs; Promote reauthorization for an additional year of the Medicare Dependent Hospital program; Oppose legislative efforts to limit the scope of the 340B program, which authorizes price discounts on the purchase of pharmaceuticals by designated safety net providers and make them aware of CMS regulatory actions regarding a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health; Responded to a request from a Missouri congressional office to clarify the number of critical access hospitals in Missouri; Letter to oppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Missouri Hospital Association reports entitled A View of Two Missouris How Insurance Coverage Affects the Health and Productivity of Its People

See Next Page for Narrative.Promote a resolution between The Higher Learning Commissions accreditation standards and Medicare nursing school payment requirements; The criteria used to designate critical access hospitals under the Medicare program; Extension of temporary restrictions of the authority of Recovery Audit Contractors and Medicare Audit Contractors to conduct reviews of Part A inpatient admissions based on the two midnight standard; Potential implementation of recommendations of the DHHS Office of Inspector General regarding changes to the designation of critical access hospitals; H.R.1250/S. 1012, The Medicare Audit Improvement Act of 2013, all sections; CMS' continuation of quarterly meetings with representatives of state hospital associations; Medicaid disproportionate share hospital payments to Missouri hospitals; Support for the Senate Finance Committee amendment (Enzi) adding S. 183 (Hospital Fairness Act) to S. Con. Res. 8 (Budget Resolution) and opposed Senate Finance Committee Amendment 0651 to S. Con. Res. 8 (Menendez); The requirements of the federal EMTALA law on hospital emergency departments; Support for The Hospital Payment Fairness Act (S. 183/H.R. 2053);

See Next Page for Narrative.Support for H.R. 1250, and S. 1012, the Medicare Audit Improvement Act of 2013; Promote the Medicare Audit Improvement Act of 2013, review the amount by congressional district of enacted reductions in hospital Medicare and Medicaid disproportionate share hospitals payments for 2013-2019 and the implications for cost-shifting of the Missouri General Assemblys decision not to expand Medicaid eligibility as authorized by the Patient Protection and Affordable Care Act of 2010; CMS proposed regulations to implement the Medicare DSH reductions authorized by the Patient Protection and Affordable Care Act of 2010; Efforts to repeal or revamp section 3141 of the Patient Protection and Affordable Care of 2010 (S. 183, H.R. 2053); CMS standards for awarding vendor contracts to Medicare Recovery Audit Contractors; Medicare hospital payment restrictions based on preventable hospital readmissions; HR 1787, The Rural Hospital Access Act, all provisions; Congressional request re: Missouri Hospital Associations stance on the Patient Protection and Affordable Care Act of 2010 at the time of its enactment; Congressional inquiry re: the amount of Medicare bad debt incurred by Missouris hospitals and the effect of the Obama Administrations proposal in its proposed FFY 2014 budget to restrict Medicares payments to partly offset Medicare bad debt costs; Oppose a proposal included in the Obama Administrations proposed budget for FFY 2014 that would preclude designation as a critical access hospital for any hospital facility located within 10 miles of another hospital; Congressional request regarding federally qualified health centers in Missouri; Request for CMS to update its list of skilled nursing facilities to include swing-bed providers.

See Next Page for Narrative.Proposals to restrict states use of provider taxes -Promoted H.R. 1250, the Medicare Audit Improvement Act of 2013, and encouraged cosponsors of the legislation; -Discussed ways that the Missouri Hospital Association might be of assistance in doing modeling of the financial implications on Missouri hospitals of future deficit reduction proposals; -Provided information regarding hospitals within the congressional districts as revised by the congressional redistricting process; -Discuss issues concerning states use of provider taxes to fund their Medicaid programs and reductions in state disproportionate share hospital payments enacted in the Patient Protection and Affordable Care Act of 2010; Provided written material on those topics; -Promoted efforts to repeal or revamp section 3141 of the Patient Protection and Affordable Care of 2010 (S. 183, Senate amendment to the U.S. Senates Budget Resolution for FY 2014); -Provided information regarding the implementation of Medicare Accountable Care Organizations authorized by the Patient Protection and Affordable Care Act of 2010; -Responded to a request from a Missouri congressional office to review and comment upon proposed legislation to create new federal qualifications and payment changes for community mental health centers; Discussed arrangements for a potential 2013 trip by CMS officials to tour rural hospitals in Missouri; 340B pharmaceutical purchasing program; States reliance on federal funding and its effect on ratings of their bonding capacity by bond ratings organizations; CMS report on the agencys implementation of the Medicare Recovery Audit Contractor program in FY 2011; Nomination of a member of the Missouri Hospital Association staff to the National Advisory Council of the National Health Services Corps; Implications of a federally-authorized expansion of Medicaid eligibility on private health insurance premiums.

See Next Page for Narrative.CMS design and implementation of Missouris federally-facilitated health insurance exchange (Marketplace); Preventing and Reducing Improper Medicare and Medicaid Expenditures act of 2013; "Dear Colleague" letter by Congresswoman Jenkins (R-KS) regarding Medicare payments for inpatient rehabilitation services Regulatory standards to create a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health plans; EHR incentives for Rural Health Clinics regarding H.R. 986, the Rural Clinic Fairness Act; Hospital financial performance metrics and trends; Medicare sustainable growth rate formula for determining payments for physician services under the Medicare program; Promote H.R. 1250 and S. 1012, regarding accountability standards for Medicare Recovery Audit Contractors and other program integrity initiatives; Ooppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Promote S. 183 and H.R. 2053, concerning repeal of section 3141 of the Patient Protection and Affordable Care Act of 2010; Oppose legislative proposals to restrict states ability to use provider taxes to fund their Medicaid programs; Promote reauthorization for an additional year of the Medicare Dependent Hospital program; Oppose legislative efforts to limit the scope of the 340B program, which authorizes price discounts on the purchase of pharmaceuticals by designated safety net providers and make them aware of CMS regulatory actions regarding a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health; Responded to a request from a Missouri congressional office to clarify the number of critical access hospitals in Missouri; Letter to oppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Missouri Hospital Association reports entitled A View of Two Missouris How Insurance Coverage Affects the Health and Productivity of Its People

See Next Page for Narrative.CMS design and implementation of Missouris federally-facilitated health insurance exchange (Marketplace); Preventing and Reducing Improper Medicare and Medicaid Expenditures act of 2013; "Dear Colleague" letter by Congresswoman Jenkins (R-KS) regarding Medicare payments for inpatient rehabilitation services Regulatory standards to create a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health plans; EHR incentives for Rural Health Clinics regarding H.R. 986, the Rural Clinic Fairness Act; Hospital financial performance metrics and trends; Medicare sustainable growth rate formula for determining payments for physician services under the Medicare program; Promote H.R. 1250 and S. 1012, regarding accountability standards for Medicare Recovery Audit Contractors and other program integrity initiatives; Ooppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Promote S. 183 and H.R. 2053, concerning repeal of section 3141 of the Patient Protection and Affordable Care Act of 2010; Oppose legislative proposals to restrict states ability to use provider taxes to fund their Medicaid programs; Promote reauthorization for an additional year of the Medicare Dependent Hospital program; Oppose legislative efforts to limit the scope of the 340B program, which authorizes price discounts on the purchase of pharmaceuticals by designated safety net providers and make them aware of CMS regulatory actions regarding a grace period for the payment of premiums for coverage in a federally-facilitated exchange or qualified health; Responded to a request from a Missouri congressional office to clarify the number of critical access hospitals in Missouri; Letter to oppose the DHHS OIGs recommendations for changes in standards for designating critical access hospitals; Missouri Hospital Association reports entitled A View of Two Missouris How Insurance Coverage Affects the Health and Productivity of Its People

See Next Page for Narrative.Promote a resolution between The Higher Learning Commissions accreditation standards and Medicare nursing school payment requirements; The criteria used to designate critical access hospitals under the Medicare program; Extension of temporary restrictions of the authority of Recovery Audit Contractors and Medicare Audit Contractors to conduct reviews of Part A inpatient admissions based on the two midnight standard; Potential implementation of recommendations of the DHHS Office of Inspector General regarding changes to the designation of critical access hospitals; H.R.1250/S. 1012, The Medicare Audit Improvement Act of 2013, all sections; CMS' continuation of quarterly meetings with representatives of state hospital associations; Medicaid disproportionate share hospital payments to Missouri hospitals; Support for the Senate Finance Committee amendment (Enzi) adding S. 183 (Hospital Fairness Act) to S. Con. Res. 8 (Budget Resolution) and opposed Senate Finance Committee Amendment 0651 to S. Con. Res. 8 (Menendez); The requirements of the federal EMTALA law on hospital emergency departments; Support for The Hospital Payment Fairness Act (S. 183/H.R. 2053);

See Next Page for Narrative. Medicare payments to certified registered nurse anesthetists for pain management services and Support for Associations related letter; Opposing budget reconciliation proposals that would reduce states capacity to use provider taxes to fund their Medicaid programs; Proposals to restrict states use of provider taxes to fund their Medicaid programs in budget reconciliation legislation pending in the House Energy and Commerce Committee; Support for H.R. 5651 based on its provisions to reduce the incidence and severity of shortages of drugs and other pharmaceuticals; The revision in a final rule of 42 C.F.R. 482.12 to require selected hospitals, including governmental hospitals, to have a physician as a member of the hospital governing board; Missouri Hospitals and their placement in congressional districts redrawn in the redistricting process. Oppose restrictions on states use of provider taxes to fund their Medicaid programs as a funding mechanism for extending subsidized interest rates on federal Stafford student loans; Development and sponsorship of legislation that would set new standards governing the ability of Medicare program integrity contractors to require health care providers to submit medical records and supporting documentation for review; H.R. 5707 (Physician Payment Innovation Act of 2012); Medicare Payment Advisory Commissions report regarding the delivery and financing of hospitals and other health care services in rural regions; S. 2620/H.R. 5943, to reauthorize the Medicare Dependent Hospital program. Regulatory and payment topics, generally; Support to: 1) consider hospitals need for stability and predictability in making their spending and policy decisions; 2) support provisions of H.R. 2245/S. 296/H.R. 3839 to respond to concerns about shortages of drugs and other pharmaceutical products; 3) reauthorize the Medicare Dependent Hospital program before it lapses on October 1, 2012; 4) repeal section 3141 of the Patient Protection and Affordable Care Act of 2010; 5) examine the administrative burdens associated with the demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; and 6) consider the Missouri Hospital Associations written observations regarding the budget proposal adopted by the U.S. House of Representatives regarding health care financing.

See Next Page for Narrative. Medicare payments to certified registered nurse anesthetists for pain management services and Support for Associations related letter; Opposing budget reconciliation proposals that would reduce states capacity to use provider taxes to fund their Medicaid programs; Proposals to restrict states use of provider taxes to fund their Medicaid programs in budget reconciliation legislation pending in the House Energy and Commerce Committee; Support for H.R. 5651 based on its provisions to reduce the incidence and severity of shortages of drugs and other pharmaceuticals; The revision in a final rule of 42 C.F.R. 482.12 to require selected hospitals, including governmental hospitals, to have a physician as a member of the hospital governing board; Missouri Hospitals and their placement in congressional districts redrawn in the redistricting process. Oppose restrictions on states use of provider taxes to fund their Medicaid programs as a funding mechanism for extending subsidized interest rates on federal Stafford student loans; Development and sponsorship of legislation that would set new standards governing the ability of Medicare program integrity contractors to require health care providers to submit medical records and supporting documentation for review; H.R. 5707 (Physician Payment Innovation Act of 2012); Medicare Payment Advisory Commissions report regarding the delivery and financing of hospitals and other health care services in rural regions; S. 2620/H.R. 5943, to reauthorize the Medicare Dependent Hospital program. Regulatory and payment topics, generally; Support to: 1) consider hospitals need for stability and predictability in making their spending and policy decisions; 2) support provisions of H.R. 2245/S. 296/H.R. 3839 to respond to concerns about shortages of drugs and other pharmaceutical products; 3) reauthorize the Medicare Dependent Hospital program before it lapses on October 1, 2012; 4) repeal section 3141 of the Patient Protection and Affordable Care Act of 2010; 5) examine the administrative burdens associated with the demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; and 6) consider the Missouri Hospital Associations written observations regarding the budget proposal adopted by the U.S. House of Representatives regarding health care financing.

See Next Page for Narrative. Medicare payments to certified registered nurse anesthetists for pain management services and Support for Associations related letter; Opposing budget reconciliation proposals that would reduce states capacity to use provider taxes to fund their Medicaid programs; Proposals to restrict states use of provider taxes to fund their Medicaid programs in budget reconciliation legislation pending in the House Energy and Commerce Committee; Support for H.R. 5651 based on its provisions to reduce the incidence and severity of shortages of drugs and other pharmaceuticals; The revision in a final rule of 42 C.F.R. 482.12 to require selected hospitals, including governmental hospitals, to have a physician as a member of the hospital governing board; Missouri Hospitals and their placement in congressional districts redrawn in the redistricting process. Oppose restrictions on states use of provider taxes to fund their Medicaid programs as a funding mechanism for extending subsidized interest rates on federal Stafford student loans; Development and sponsorship of legislation that would set new standards governing the ability of Medicare program integrity contractors to require health care providers to submit medical records and supporting documentation for review; H.R. 5707 (Physician Payment Innovation Act of 2012); Medicare Payment Advisory Commissions report regarding the delivery and financing of hospitals and other health care services in rural regions; S. 2620/H.R. 5943, to reauthorize the Medicare Dependent Hospital program. Regulatory and payment topics, generally; Support to: 1) consider hospitals need for stability and predictability in making their spending and policy decisions; 2) support provisions of H.R. 2245/S. 296/H.R. 3839 to respond to concerns about shortages of drugs and other pharmaceutical products; 3) reauthorize the Medicare Dependent Hospital program before it lapses on October 1, 2012; 4) repeal section 3141 of the Patient Protection and Affordable Care Act of 2010; 5) examine the administrative burdens associated with the demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; and 6) consider the Missouri Hospital Associations written observations regarding the budget proposal adopted by the U.S. House of Representatives regarding health care financing.

See Next Page for Narrative. Medicare payments to certified registered nurse anesthetists for pain management services and Support for Associations related letter; Opposing budget reconciliation proposals that would reduce states capacity to use provider taxes to fund their Medicaid programs; Proposals to restrict states use of provider taxes to fund their Medicaid programs in budget reconciliation legislation pending in the House Energy and Commerce Committee; Support for H.R. 5651 based on its provisions to reduce the incidence and severity of shortages of drugs and other pharmaceuticals; The revision in a final rule of 42 C.F.R. 482.12 to require selected hospitals, including governmental hospitals, to have a physician as a member of the hospital governing board; Missouri Hospitals and their placement in congressional districts redrawn in the redistricting process. Oppose restrictions on states use of provider taxes to fund their Medicaid programs as a funding mechanism for extending subsidized interest rates on federal Stafford student loans; Development and sponsorship of legislation that would set new standards governing the ability of Medicare program integrity contractors to require health care providers to submit medical records and supporting documentation for review; H.R. 5707 (Physician Payment Innovation Act of 2012); Medicare Payment Advisory Commissions report regarding the delivery and financing of hospitals and other health care services in rural regions; S. 2620/H.R. 5943, to reauthorize the Medicare Dependent Hospital program. Regulatory and payment topics, generally; Support to: 1) consider hospitals need for stability and predictability in making their spending and policy decisions; 2) support provisions of H.R. 2245/S. 296/H.R. 3839 to respond to concerns about shortages of drugs and other pharmaceutical products; 3) reauthorize the Medicare Dependent Hospital program before it lapses on October 1, 2012; 4) repeal section 3141 of the Patient Protection and Affordable Care Act of 2010; 5) examine the administrative burdens associated with the demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; and 6) consider the Missouri Hospital Associations written observations regarding the budget proposal adopted by the U.S. House of Representatives regarding health care financing.

See Next Page for Narrative. Congressional efforts to restrict states use of provider taxes to fund their Medicaid programs; Advocated the consideration for hospitals need for stability and predictability in making their spending and policy decisions; 2) support expected legislative efforts to repeal or revamp section 3141 of the Patient Protection and Affordable Care Act of 2010; 3) support expected legislative efforts to assess and limit the administrative burdens imposed by demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; 4) reauthorize the Medicare Dependent Hospital Payment program for one year effective October 1, 2012, through H.R. 5943 or S. 2620; 5) oppose congressional proposals to curtail states capacity to use provider taxes to generate federal matching funds for their Medicaid programs; 6) repeal or revise the Medicare sustainable growth rate formula used to determine Medicare physician payments and do so without reducing payments to non-physician providers to offset the cost of doing so; 7) reject future congressional proposals to terminate the designation of critical access hospitals that qualify for separate payment and regulatory standards; Additional support for H.R. 5943, provisions relateed to Medicare Dependent Hospital programs; Medicare Payment Advisory Commissions report regarding the delivery and financing of hospitals and other health care services in rural regions; Promoted awareness of and support for the Center for Medicare and Medicaid Services promulgation of regulations to clarify the authority of certified registered nurse anesthetists to be paid to provide pain management services to Medicare enrollees; Regulatory standards governing the use of tasers and weapons by hospital security staff; Worked on the wording and content of draft legislation to assess and limit the administrative burdens imposed by demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; H.R. 5943 or S. 2620, with respect to payments received by Missouri hospitals under the Medicare Low-Volume Hospital program; Expected legislation to assess and limit the administrative burdens imposed by demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; Discussed the effect the RAC program is having on Missouri hospitals.

See Next Page for Narrative. Medicare payments to certified registered nurse anesthetists for pain management services and Support for Associations related letter; Opposing budget reconciliation proposals that would reduce states capacity to use provider taxes to fund their Medicaid programs; Proposals to restrict states use of provider taxes to fund their Medicaid programs in budget reconciliation legislation pending in the House Energy and Commerce Committee; Support for H.R. 5651 based on its provisions to reduce the incidence and severity of shortages of drugs and other pharmaceuticals; The revision in a final rule of 42 C.F.R. 482.12 to require selected hospitals, including governmental hospitals, to have a physician as a member of the hospital governing board; Missouri Hospitals and their placement in congressional districts redrawn in the redistricting process. Oppose restrictions on states use of provider taxes to fund their Medicaid programs as a funding mechanism for extending subsidized interest rates on federal Stafford student loans; Development and sponsorship of legislation that would set new standards governing the ability of Medicare program integrity contractors to require health care providers to submit medical records and supporting documentation for review; H.R. 5707 (Physician Payment Innovation Act of 2012); Medicare Payment Advisory Commissions report regarding the delivery and financing of hospitals and other health care services in rural regions; S. 2620/H.R. 5943, to reauthorize the Medicare Dependent Hospital program. Regulatory and payment topics, generally; Support to: 1) consider hospitals need for stability and predictability in making their spending and policy decisions; 2) support provisions of H.R. 2245/S. 296/H.R. 3839 to respond to concerns about shortages of drugs and other pharmaceutical products; 3) reauthorize the Medicare Dependent Hospital program before it lapses on October 1, 2012; 4) repeal section 3141 of the Patient Protection and Affordable Care Act of 2010; 5) examine the administrative burdens associated with the demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; and 6) consider the Missouri Hospital Associations written observations regarding the budget proposal adopted by the U.S. House of Representatives regarding health care financing.

See Next Page for Narrative. Congressional efforts to restrict states use of provider taxes to fund their Medicaid programs; Hospitals need for stability and predictability in making their spending and policy decisions; support expected legislative efforts to repeal or revamp section 3141 of the Patient Protection and Affordable Care Act of 2010; Support expected legislative efforts to assess and limit the administrative burdens imposed by demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; Reauthorize the Medicare Dependent Hospital Payment program for one year effective October 1, 2012, through H.R. 5943 or S. 2620; Oppose congressional proposals to curtail states capacity to use provider taxes to generate federal matching funds for their Medicaid programs; Repeal or revise the Medicare sustainable growth rate formula used to determine Medicare physician payments and do so without reducing payments to non-physician providers to offset the cost of doing so; Reject future congressional proposals to terminate the designation of critical access hospitals which qualify for separate payment and regulatory standards; Medicare Dependent Hospital provisions in H.R. 5943, Rural Hospital Access Act of 2012; Medicare Payment Advisory Commissions report regarding the delivery and financing of hospitals and other health care services in rural regions; Promoted congressional awareness of and support for the Center for Medicare & Medicaid Services promulgation of regulations to clarify the authority of certified registered nurse anesthetists to be paid to provide pain management services to Medicare enrollees; Provided background information to congressional staff to respond to a query regarding regulatory standards governing the use of tasers and weapons by hospital security staff; Wording and content of draft legislation to assess and limit the administrative burdens imposed by demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives; Conducted and conveyed the results of research needed to respond to a query regarding the number of Missouri hospitals receiving payments under the Medicare Low-Volume Hospital program, in response to H.R. 5943/ S. 2620, Rural Hospital Access Act of 2012; Proposed draft legislation to assess and limit the administrative burdens imposed by demands for records by Medicare Recovery Audit Contractors and other program integrity initiatives;

Grant funding by the Agency for Healthcare Research and Quality of a Health Research and Education Trust on "Development and Demonstrations of a Surgical United-based Safety Program (SUSP) to Reduce Surgical Site Infections and Other Surgical Complications." Review implications of the Commitment to American Prosperity Act of 2011" for Missouri. CMS' certification and survey process. H.R. 1398 as it relates to the calculation of provider taxes in Medicare cost reports. Proposed funding reductions in H.R. 1363 for hospital disaster preparedness programs. Review/snalyze CMS actions taken against a member hospital for alleged violation of Medicare Conditions of Participation. Profile of Missouri's hospitals; financial projections of Medicare margins through 2019; reductions in the use of state provider tax as proposed in the President's first budget proposal of 2011; CMS standards for disproportionate share hospital payments; CMS treatment of provider taxes in Medicare cost reports and the benefits of H.R. 1398; preservation of Medicare critical access hospital, Medicare-dependent hospital and sole community hospital payments; federal funding of poison control centers; and the implications of the FY 2012 budget proposal advanced by Rep. Paul Ryan. Advocated Health Resources and Services Administration to implement funding reductions of the final continuing resolution for FY 2011 by avoiding disproportionate cuts to children's graduate medical education payments and funding for poison control centers

Grant funding by the Agency for Healthcare Research and Quality of a Health Research and Education Trust on "Development and Demonstrations of a Surgical United-based Safety Program (SUSP) to Reduce Surgical Site Infections and Other Surgical Complications." Review implications of the Commitment to American Prosperity Act of 2011" for Missouri. CMS' certification and survey process. H.R. 1398 as it relates to the calculation of provider taxes in Medicare cost reports. Proposed funding reductions in H.R. 1363 for hospital disaster preparedness programs. Review/snalyze CMS actions taken against a member hospital for alleged violation of Medicare Conditions of Participation. Profile of Missouri's hospitals; financial projections of Medicare margins through 2019; reductions in the use of state provider tax as proposed in the President's first budget proposal of 2011; CMS standards for disproportionate share hospital payments; CMS treatment of provider taxes in Medicare cost reports and the benefits of H.R. 1398; preservation of Medicare critical access hospital, Medicare-dependent hospital and sole community hospital payments; federal funding of poison control centers; and the implications of the FY 2012 budget proposal advanced by Rep. Paul Ryan. Advocated Health Resources and Services Administration to implement funding reductions of the final continuing resolution for FY 2011 by avoiding disproportionate cuts to children's graduate medical education payments and funding for poison control centers

Federal challenges and opportunities for Missouri hospitals, generally; Oppose legislative and executive branch proposals to restrict states' use of provider taxes to fund their Medicaid programs; Provider tax restrictions included in the Obama Administration's 10-year deficit reduction proposal; Support for eliminating the current "sustainable growth rate" formula used to set Medicare physician fees and replacing it without reducing hospital payments to offset the cost of doing so; Support for repealing a section of the Patient Protection and Affordable Care Act of 2010 that changed the budget neutrality test for the changes in the "rural floor" component of the Medicare Average Wage Index calculations; Support for legislation that prevents federal Medicare contractors form recalculating lower Medicare payments to critical access hospitals; Deficit reduction legislation, generally; Missouri hospitals' economic contributions, including actual and projected Medicare margins for Missouri hospitals; Support for access to physician services in rural Missouri; and Support for maintaining hospital payments for critical access, sole community and Medicare-dependent hospitals. CMS' survey and certification issues. HRSA's Office of Rural Health Programs AHRQ's MONAHRQ program for presenting health care quality data. Use of provider taxes to fund Medicaid programs. Proposed cuts in payments for graduate medical education. Oppose restrictions on states' use of provider taxes. Promote the elimination or restrictions on Medicare payments for bad debt expenses, cuts in graduate medical education payments and the consolidation of Medicaid matching fund rates. Coding offset included in the agency's proposed regulatory changes to the Medicare prospective payment system. Legislative provisions that were codified in the Budget Control Act of 2011. The repeal of a section of the Patient Protection and Affordable Care Act of 2010 that changed the budget neutrality test for the changes in the "rural floor" component of the Medicare Average Wage Index calculations. National Labor Relations Board's regulations on the posting of notices of workers' rights to engage in collective bargaining Issues related to Missouri's reliance on provider taxes to fund its Medicaid program.

-Prepared a letter to CMS to promote a one-year delay in implementing the findings of pending DSH audits and to express concern about the imposition of potential DSH payment reductions in advance of expanded coverage associated with federal health reform legislation. -Promoted legislator endorsement of a letter to CMS expressing concern about a proposed CMS regulation on the ability of critical access hospitals to include state provider taxes in their cost reports. -Promoted legislator endorsement of a letter to DHHS promoting a one-year delay in implementing the findings of pending DSH audits. -Responded to a legislative staff query regarding the Missouri Hospital Associations stance on H.R. 2381, the Nurse and Health Care Worker Protection Act of 2009. -Forwarded to congressional staff a letter to Secretary of Health and Human Services from an MHA-member hospital regarding concerns about policies concerning the definition of DSH-allowable costs and the application of pending DSH audits. -Distributed information on hospitals financial performance, with an emphasis on Medicare margins. -Promoted congressional action to delay applying the findings of pending DSH audits until state fiscal year 2012. -Supported legislation to revamp the Medicare physician payment system and permanently eliminate the sustainable growth rate component of the payment formula. -Expressed thanks to the members of the congressional delegation for past assistance to hospitals.

- Responded to a member hospital regarding a congressional query on identification of cost-effective treatments for Medicare patients - Promoted funding in the FY2011 Senate Labor-HHS appropriations bill of hospital trauma care programs authorized by P.L. 111-148 - Promoted a six-month extension of a lapsing increase in states Medicaid Federal Medicaid Assistance Percentage as an amendment to H.R. 1586 - Notification of November 2010 legislative recognition award for a retiring legislator - CMS ? regulatory standards for standards of treatment supervision standards applicable to Medicare physicians - CMS ? standards regarding the inspection and enforcement functions of CMS hospital survey and certification branch - Extension of implementation deadline of and standards of Medicaid disproportionate share hospital audits - CMS treatment of state Medicaid provider taxes in Medicare cost reports of Critical Access Hospitals - CMS ? CMS standards for treatment of insurance coverage in determining which costs are compensable by Medicaid disproportionate share hospital payments - DHHS ? regulatory definition of medical loss ratios of health insurers pursuant to the Affordable Care Act

Specify lobbying issues: responded to a legislative staff query regarding efforts to modify proposed regulations of the Centers for Medicare and Medicaid Services relating to health information technology. Responded to a legislative staff query regarding hospitals receiving section 508 area wage reclassifications. Initiated a query regarding a legislators availability to receive a service award. H.R. 3590 sections related to productivity adjustments, the creation of an independent Medicare payment board, federal funding of Medicaid costs associated with expansions of eligibility, reporting by states of Medicaid payment methodologies and rates, reduction of Medicaid and Medicare disproportionate share hospital payments, payment reductions associated with preventable readmissions, Medicare value-based purchasing arrangements, payment changes associated with geographic variation in per-capita spending, demonstration projects for new payment and delivery models, the 340B pharmaceutical discount program, payment adjustments for certain rural hospitals, payment for rural health clinics, credentialing of medical staff involved in telemedicine, and revision of the sustainable growth rate formula for setting physician fee schedules. Also, promoted amendments to ensure protection of safety net financing arrangements in St. Louis. H.R. 4213 and others. Promoted revision of the sustainable growth rate formula for setting physician fee schedules, enactment of a six-month extension of financial assistance to states using the FMAP, renewal of various expiring provisions related to hospital and ambulance reimbursement, clarification of the ability of certain physicians to receive federal payment to offset the cost of health information technology.

Specify lobbying issues: responded to a legislative staff query regarding efforts to modify proposed regulations of the Centers for Medicare and Medicaid Services relating to health information technology. Responded to a legislative staff query regarding hospitals receiving section 508 area wage reclassifications. Initiated a query regarding a legislators availability to receive a service award. H.R. 3590 sections related to productivity adjustments, the creation of an independent Medicare payment board, federal funding of Medicaid costs associated with expansions of eligibility, reporting by states of Medicaid payment methodologies and rates, reduction of Medicaid and Medicare disproportionate share hospital payments, payment reductions associated with preventable readmissions, Medicare value-based purchasing arrangements, payment changes associated with geographic variation in per-capita spending, demonstration projects for new payment and delivery models, the 340B pharmaceutical discount program, payment adjustments for certain rural hospitals, payment for rural health clinics, credentialing of medical staff involved in telemedicine, and revision of the sustainable growth rate formula for setting physician fee schedules. Also, promoted amendments to ensure protection of safety net financing arrangements in St. Louis. H.R. 4213 and others. Promoted revision of the sustainable growth rate formula for setting physician fee schedules, enactment of a six-month extension of financial assistance to states using the FMAP, renewal of various expiring provisions related to hospital and ambulance reimbursement, clarification of the ability of certain physicians to receive federal payment to offset the cost of health information technology.

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

-Rural Health Issues: H.R. 362, Rural Hospital Assistance Act; S. 318, Medicare Rural Health Access Improvement Act; S.307 and H.R. 668, Critical Access Flexibility Act; S. 628, Conrad State 30 Improvement Act; S. 1279/H.R. 3256, Rural Community Hospital Demonstration Extension Act; S.1157, Craig Thomas Rural Hospital and Provider Equity Act. -Health Reform Legislation H.R. 3200 and Americas Healthy Future Act of 2009 (not yet numbered) and S. 1679, cost analysis of the effect of pending legislation on Missouri hospitals; implications of proposed Medicaid expansions; payments to hospitals under a public plan of coverage; the use of disproportionate share hospital payments to fund health reform; the creation of an autonomous payment council to set Medicare payment rates, and an agreement by several national hospital organizations to support payment reductions to provide funding for health reform. H.R. 3200, inclusion of expanded 340B pharmaceutical purchasing discount program, Medicare payment reductions to physicians imposed by the use of a sustainable growth rate formula in calculating physician payments and restrictions on the ability of physicians to refer their patients to hospitals in which the physicians have an ownership interest. -H.R. 444, 340B Program Improvement and Integrity Act. -Legislation to prevent the implementation of a 21% reduction in Medicare payments to physicians scheduled under current law to take effect January 1, 2010. -Legislative or regulatory action to resolve inconsistent coverage determinations among various Medicare contractors, including Medicare Administrative Contractors, Home Health/Hospice Medicare Administrative Contractors, Recovery Audit Contractors, Quality Improvement Organizations and Durable Medical Equipment Regional Contractors. -Provided requested information on the distribution by category of public and private insurance coverage in Missouri.

1.) Responded to a legislative staff inquiry regarding Missouri hospitals' access to financing for capital improvements through the bond market. 2) H.R. 3590/H.R. 3962 -- sections relating to expansions of coverage through Medicaid or a health insurance exchange; the financing of the legislation through reductions in Medicare and Medicaid payments to hospitals; the imposition of Medicare hospital payment reductions based on comparisons of actual and expected rates of readmissions; equity among states in their responsibility to fund the cost of expanding Medicaid under the legislation; and the proposed authorization of Medicare coverage for persons age 55-64.

1.) Responded to a legislative staff inquiry regarding Missouri hospitals' access to financing for capital improvements through the bond market. 2) H.R. 3590/H.R. 3962 -- sections relating to expansions of coverage through Medicaid or a health insurance exchange; the financing of the legislation through reductions in Medicare and Medicaid payments to hospitals; the imposition of Medicare hospital payment reductions based on comparisons of actual and expected rates of readmissions; equity among states in their responsibility to fund the cost of expanding Medicaid under the legislation; and the proposed authorization of Medicare coverage for persons age 55-64.

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

S. 543/H.R. - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008