• Implementation issues affecting hospitals related to P.L. 111-148, the Patient Protection and Affordable Care Act, and P.L. 111-152, the Health Care and Education Reconciliation Act of 2010

Duration: November 1, 2010 to June 30, 2012

General Issues: Medicare/Medicaid

Spending: about $50,000 (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 2010: House of Representatives, U.S. Senate, Centers For Medicare and Medicaid Services (CMS)