• Reform of the Medicare ambulatory surgery center payment system. Support for H.R. 2049, "Ambulatory Surgical Center Access Act of 2009." Payment update provisions in CMS-1414-P, "Proposed Changes to ASC Payment System and CY 2010 Payment Rates." ASC provisions in H.R. 3200, "America's Affordable Health Choices Act of 2009" and S. ____, "America's Healthy Future Act."

Duration: January 1, 2008 to September 30, 2009

General Issues: Medicare/Medicaid, Health Issues

Spending: about $350,000 (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 2008: House of Representatives, U.S. Senate, Centers For Medicare and Medicaid Services (CMS), Health & Human Services - Dept of (HHS), White House Office, Office of Management & Budget (OMB), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB),, Centers For Medicare and Medicaid Services (CMS),