• Medicare billing issue for patient-specific medications used in intrathecal pain pumps.

Duration: March 10, 2017 to September 1, 2020

General Issues: Medicare/Medicaid

Spending: about $290,000 (But it's complicated. Here's why.)

It can be tricky to figure out how much an organization spent on a particular lobbying engagement. The law only requires lobbyists to report the amount they were paid for federal lobbying each quarter rounded to the nearest $10,000—and if it's less than $3,000 in a given quarter (or less than $13,000 for organizations with in-house lobbyists), they don't have to disclose it at all. Plus, some organizations include spending that doesn’t belong in the report—for instance, money spent lobbying state governments or other legal work.

Agencies lobbied since 2017: U.S. Senate, House of Representatives, Centers For Medicare and Medicaid Services (CMS)