Lobbying Disclosure Act of 1995 (Section 5) - All Filers Are Required to Complete This Page

9. Check if this filing amends a previously filed version of this report

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code HCR

16. Specific lobbying issues

HR 3590: The Patient Protection and Affordable Care Act
Advocated in favor of non-profit, non-governmental co-op and oppose other public options proposals including the opt-out proposals.

Support coverage reaching 97% of legal residents residing in US.

Advocated support for Senate Amendment 2786 which would strengthen rural health services. Specifically, endorsed the following provisions:

1. State Offices of Rural Health (SORH), currently operating in every state, provide a crucial service to rural communities, recognizing unique challenges throughout their state. While funding levels and sources also vary from state-to-state, each state receives a portion of their funding from the U.S. Department of Health and Human Services Office of Rural Health Policy through the SORH Grant program, begun in 1991. With this grant, a SORH is expected to:
Collect and disseminate information
Coordinate rural health resources and activities state-wide
Provide technical assistance
Encourage recruitment and retention of healthcare professionals
Strengthen state, local, and federal partnerships

2. The initial language creating the SORH program, however, included a termination clause, Section 338J(k) of the Public Health Service Act. Congress has continued to fund the SORHs, despite this language, with an appropriation of approximately $9 million in FY2009.

2.340B is already going to help hospitals in the HELP bill, we are just expanding to rural health clinics
3.I am checking on number 3
4.No its just pharmacy dispensing data.

Opposed efforts to add additional individuals to the Medicare and Medicaid rolls as a means of increasing coverage due to concerns that while reimbursements are already underfunded, the proposal would also would effectively transfer an additional fiscal burden upon the states

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE,

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code HCR

16. Specific lobbying issues

HR 3962 - Affordable Health Care for America Act of 2009

Advocated to eliminate payment reductions in the form of "productivity adjustments." Advocated for health care reform that does not crowd out employer based and private insurer plans. Requested to maintain funding levels for DSH and GME Medicare payments.

Communicated support of efforts in the US House to include an amendment eliminating a federal antitrust exemption for health insurance and medical malpractice insurance companies. The Health Insurance Industry Antitrust Enforcement Act (HR 3596) would repeal the McCarran-Ferguson Act exemption from certain antitrust violations, including price fixing, bid rigging, and market allocations.

Advocated for inclusion of pilot projects similar to senate legislation be included in the House bill.

Communicated concerns that the bills negotiated rates would still be based, in part, on historically low Medicare rates. Also shared concerns about expanding eligibility for Medic aid from 133 percent of the federal poverty level to 150 percent at a time when the State of Colorado is struggling with severe budget shortfalls. Requested that both provisions be modified to previous drafts.

Advocated for provisions providing discounted drug prices for inpatient servies to both hospitals that currently access the program and those added to the program, while expanding outpatient drug discounts to childrens hospitals, cancer hospitals, critical access hospitals, Medicare-dependent hospitals, sole community hospitals and rural referral centers. Requested the vill extend provisions to inpatient expansion.

Requested that the House place an annual fee on medical device companies, as the Senate has proposed, rather than increasing the overall cuts to hospitals. As written, the $20 billion medical device manufacturer tax is an excise tax to be levied on each device sold to a provider. Therefore, the tax could be passed on directly to hospitals, resulting in an additional cut.

17. House(s) of Congress and Federal agencies Check if None

U.S. HOUSE OF REPRESENTATIVES

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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Information Update Page - Complete ONLY where registration information has changed.

20. Client new address

21. Client new principal place of business (if different than line 20)

22. New General description of client’s business or activities

LOBBYIST UPDATE

23. Name of each previously reported individual who is no longer expected to act as a lobbyist for the client

ISSUE UPDATE

24. General lobbying issue that no longer pertains

AFFILIATED ORGANIZATIONS

25. Add the following affiliated organization(s)

Internet Address:

26. Name of each previously reported organization that is no longer affiliated with the registrant or client

FOREIGN ENTITIES

27. Add the following foreign entities:

28. Name of each previously reported foreign entity that no longer owns, or controls, or is affiliated with the registrant, client or affiliated organization