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 MMM

16. Specific lobbying issues

Medicare: Continue to strongly advocate for NJs Medicare Wage Index Floor to be made permanent or extended in final FY2012 IPPS rule; Support Senate and House Congressional letters to CMS urging the agency to make changes to the proposed coding offset in the FY2012 IPPS rule; Request Senate and House Appropriators to include stable funding for the Childrens Hospitals Graduate Medical Education (CHGME) program in the FY2012 appropriations bills; Support H.R. 1656, the
Urban Medicare Dependent Preservation Act of 2011; Support relief from 25 percent rule, LTCH payment policies, and oppose reduction in skilled nursing facilities; Support H.R. 2500, the Equal Access and Parity for Multi-Campus Hospitals Act, which would ensure that multi-campus hospitals are treated fairly under the Medicare and Medicaid electronic health records incentive programs authorized in the ARRA. The bill clarifies that the EHR incentive payments should go to each campus of a multi-campus hospital system, as long as each campus meets the meaningful use requirements.

Deficit Reduction/Joint Select Committee on Deficit Reduction: The bipartisan joint select committee on deficit reduction has begun its work to crafting a plan by Nov. 23 to reduce the national deficit by at least $1.2 trillion. If Congress fails to adopt the committee's recommendations by Dec. 23, or if the committee cannot find enough savings, automatic spending cuts totaling $1.2 trillion split between defense spending and non-defense programs will take effect. Under the trigger, reductions in Medicare payments to hospitals and other providers of up to 2 percent over nine years (2013 to 2021) would automatically take effect. Those cuts would reach an estimated $41 billion in hospital payments alone and $119 billion in Medicare overall.

NJHA continues to strongly urge lawmakers to protect healthcare programs under Medicare and Medicaid as Congress continues to debate strategies and discuss the numerous Congressional proposals to rein in the national debt. Organized and participated in advocacy day on deficit reduction (July 13 and planning another one Oct 4th) to strongly urge lawmakers to oppose any additional cuts to provider payments while the debt limit discussions continue.

Express concern and opposition to certain recommendations in the Administrations proposal to the Joint Select Committee on Deficit Reduction that includes cutting Medicare by $248 billion and Medicaid by $73 billion over 10 years. The healthcare recommendations included in the proposal include reducing bad debt payments; reducing indirect medical education payments; adjusting payment updates for certain post-acute care providers, including skilled nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, a proposal to create a home health co-pay; and strengthening the IPAB which would jeopardize hospitals ability to care for patients and the training of our next generation of physicians. Any additional cuts to providers could result in threats to patient care could result in services eliminated; longer waits for care; ERs shut down; staffing reduced. Hospitals are doing more with less. There are other ways to reduce the deficit, but not on the backs of providers.

In September, NJHA sent strong letters to the Joint Select Committee on Deficit Reduction Co-Chairs and the New Jersey Congressional Delegation urging them to reject any further reductions to healthcare providers. The letters requests that provider reductions stay off the table and asks that our N.J. Congressional Delegation express strong opposition with the Administration and the Joint Select Committee to healthcare provider reductions and to please ensure patients have the access to the hospital care they need and the continued economic benefits that hospitals bring to their communities. In New Jersey, hospitals provide nearly 145,000 jobs and about $19 billion in total contributions to the state economy.

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

U.S. HOUSE OF REPRESENTATIVES, 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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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