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5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} </style> <![endif]--><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="4098"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body lang=EN-US link=blue vlink=purple style='tab-interval:.5in'> <div class=Section1> <div align=center> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 width=500 style='width:375.0pt;mso-cellspacing:0in;border:outset #616559 6.0pt; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='border:inset #616559 1.0pt;mso-border-alt:inset #616559 .75pt; padding:0in 0in 0in 0in'> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=500 style='width:375.0pt;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padding-alt: 0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td style='padding:0in 0in 0in 0in'> <p class=MsoNormal align=center style='text-align:center'><a href="http://www.hallrender.com/" title="&quot;Health Law Broadcast&quot; t "><span style='mso-fareast-font-family:"Times New Roman";mso-no-proof:yes; text-decoration:none;text-underline:none'><img border=0 width=600 height=100 id="_x0000_i1026" src="http://www.hallrender.com/email/img/HealthLawBroadcast_Header.jpg" alt="Health Law Broadcast"></span></a><span style='mso-fareast-font-family: "Times New Roman"'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1'> <td style='background:#B5B5A1;padding:3.0pt 3.0pt 3.0pt 3.0pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp; &nbsp; &nbsp; <a href="http://www.hallrender.com/?&amp;section=library" title="Hall Render Knowledge Center"><b><span style='font-size:9.0pt; font-family:"Arial","sans-serif";color:white;text-transform:uppercase; text-decoration:none;text-underline:none'>KNOWLEDGE CENTER</span></b></a> &nbsp; <strong><span style='color:#B6121B'>||</span></strong> &nbsp; <a href="mailto:hallrender@hallrender.com" title="Contact Hall Render"><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif";color:white; text-transform:uppercase;text-decoration:none;text-underline:none'>CONTACT</span></b></a> <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2'> <td valign=top style='background:white;padding:0in 0in 0in 0in'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:3'> <td valign=top style='background:white;padding:0in 0in 0in 0in'> <div align=center> <table class=MsoNormalTable border=0 cellpadding=0 width="90%" style='width:90.0%;mso-cellspacing:1.5pt;mso-yfti-tbllook:1184;mso-padding-alt: 0in 5.4pt 0in 5.4pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:.75pt .75pt .75pt .75pt'> <div id="previewcell:cell1"> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;background:white; mso-yfti-tbllook:1184;mso-padding-alt:3.75pt 3.75pt 3.75pt 3.75pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style='padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p align=right style='text-align:right'><strong><span style='font-size: 10.0pt;font-family:"Arial","sans-serif";color:#888B7D'>March 29, 2010</span></strong><span style='font-size:13.0pt;font-family:"Arial","sans-serif";color:#888B7D'><o:p></o:p></span></p> <p style='text-align:justify'><em><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>This installment of Hall Render's Health Law Broadcast series on health care reform is designed to provide you with a brief update on significant developments from the previous week.</span></em><span style='font-size:13.0pt;font-family: "Arial","sans-serif"'><o:p></o:p></span></p> <p style='text-align:justify'><span style='font-size:13.5pt;color:#B7060B'>Health Reform&nbsp;- A Brief Overview of the Early Deliverables and Major Provisions Effective in 2010</span><span style='font-size:13.0pt; font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p style='text-align:justify'><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (the &quot;Act&quot;) making health care reform the law of the land.&nbsp; Since then, both the House and Senate have agreed upon&nbsp;the Health Care and Education Reconciliation&nbsp;Act of 2010 (the &quot;Reconciliation Act&quot;) that includes a number of budget-based corrections to the Act.&nbsp; President Obama is expected to sign&nbsp;the Reconciliation Act in the coming days.&nbsp;Thus ends the long, strange trip called health care reform.&nbsp; Members of Congress are truckin' home for a two-week recess.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>Both the Act and the Reconciliation Act (together the &quot;Health Reform Act&quot;) constitute a complex, intricate piece of health reform legislation.&nbsp; Following is a list of some of the major provisions of the Health Reform Act scheduled to go into effect beginning in 2010.&nbsp; Most of the measures made effective in 2010 have a relatively limited direct effect on health care providers such as hospitals.&nbsp; The Health Reform Act provides for a progressive phase-in of its provisions from 2010 through 2018 with the most significant changes affecting hospitals and other providers in 2014 when individuals are required to purchase health insurance and the insurance exchanges are up and running.&nbsp;&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>Implementation timelines for subsequent years and in-depth analyses on the provisions introduced below as they affect the various stakeholders will be forthcoming in future Health Law Broadcasts.<o:p></o:p></span></p> <p style='text-align:justify'><strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>PROVISIONS AFFECTING HOSPITALS AND OTHER HEALTH CARE PROVIDERS</span></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'><o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Section 501(c)(3) Charitable Hospitals - Additional Requirements</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Section 9007 of the Act amends Section 501 of the Internal Revenue Code of 1986 to require tax-exempt 501(c)(3) hospitals, every three (3) years, to conduct a &quot;community health needs assessment&quot; taking into account input from individuals in the hospital community including those with special knowledge or expertise in public health.&nbsp; The hospital must adopt an implementation strategy to meet the community needs identified by the assessment.&nbsp; Further, the tax-exempt hospital must put into place the following policies:<o:p></o:p></span></p> <p style='margin-left:.75in;text-align:justify;text-indent:-.25in; mso-list:l0 level1 lfo4'><![if !supportLists]><span style='font-size: 10.0pt;font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family: Symbol;color:#616459'><span style='mso-list:Ignore'>·<span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><i><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Financial Policies</span></i><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>&nbsp;addressing eligibility criteria for financial assistance including free or discounted care, the basis for calculating amounts charged to patients, the method for applying for financial assistance, and the collection and credit agency reporting actions the hospital may take, if the hospital does not have a separate billing and collections policy; and <o:p></o:p></span></p> <div style='align: left'> <p class=MsoListParagraph style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;margin-left:.75in;mso-add-space:auto;text-align:justify; text-indent:-.25in;mso-list:l0 level1 lfo4'><![if !supportLists]><span style='font-size:10.0pt;font-family:Symbol;mso-fareast-font-family: Symbol;mso-bidi-font-family:Symbol;color:#616459'><span style='mso-list:Ignore'>·<span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><i><span style='font-size:10.0pt; font-family:"Arial","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#616459'>Emergency Medical Care Policy </span></i><span style='font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:#616459'>making it clear that the hospital is obligated to provide care for emergency medical conditions regardless of a patient's eligibility for financial assistance.<o:p></o:p></span></p> </div> <blockquote style='margin-top:5.0pt;margin-right:0in;margin-bottom: 5.0pt'> <blockquote style='margin-top:5.0pt;margin-right:0in;margin-bottom: 5.0pt'> <p style='text-align:justify'><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>Under Section 9007, tax-exempt hospitals are prohibited from charging patients eligible for financial assistance, more than the lowest amounts billed to insured patients for emergency and other medically necessary care, and must not engage in &quot;extraordinary collection actions&quot; prior to making a &quot;reasonable effort&quot; to determine whether a patient is eligible for financial assistance under its policy.&nbsp; The Health Reform Act authorizes the promulgation of implementing regulations and guidance to carry out these additional requirements for 501(c)(3) hospitals, and any hospital not complying is subject to an excise tax of $50,000.&nbsp; Section 9007 of the Act is effective for taxable years following enactment beginning in 2010 according to an implementation timeline prepared jointly by several committees of the House of Representatives.&nbsp; Further guidance will be necessary to define what constitutes &quot;extraordinary collections actions&quot; and &quot;reasonable efforts&quot; [to determine eligibility for financial assistance].&nbsp;&nbsp;&nbsp;<o:p></o:p></span></p> </blockquote> </blockquote> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Rural Hospitals</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; The Act extends Medicare payment protections for small rural hospitals that play a crucial role in providing care in underserved communities.&nbsp; For example, Section 3122 of the Act provides for the extension of Medicare &quot;reasonable cost payments&quot; for clinical diagnostic lab services provided in rural hospitals.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Provider Screening</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Section 6401 of the Act and Section 1304 of the Reconciliation Act provide for federal health care program provider/supplier screening and enhanced oversight for new providers and suppliers to aid in the government's efforts to reduce fraud and abuse.&nbsp; Screening must include licensure checks and may include criminal background checks, fingerprinting, and unscheduled and unannounced site visits.&nbsp; Fees are assessed for such screenings and effective dates vary depending on the status of the provider/supplier.&nbsp; The Secretary of HHS may impose a temporary moratorium on the enrollment of new providers and suppliers if the Secretary determines the moratorium is necessary to combat fraud and abuse.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Enhancing Primary Care</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Section 10503 of the Act provides funding to construct new and expand existing community health centers.&nbsp; The Act also provides for increased funding for scholarships and loan repayments for primary care practitioners working in underserved areas.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Physician Self-Referral Limitations</span></u></strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Section 6001 severely restricts physician ownership in hospitals under the Stark Law &quot;whole hospital exception,&quot; effectively prohibiting future investment in new hospitals and limiting the expansion of existing hospitals.&nbsp; Section 6003 of the Act amends the &quot;in-office ancillary services exception&quot; under the Stark Law to require a physician to disclose to patients that they may receive MRI, CT and PET imaging services provided by the physician from other local providers and, further, to require the physician to furnish a list of alternate providers in the patient's local area.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Drug Manufacturers</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; The Act authorizes the FDA to grant biologic drug manufacturers twelve (12) years of exclusive use before generic manufacturers can develop generic versions.&nbsp;<o:p></o:p></span></p> <p style='text-align:justify'><strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>PROVISIONS BENEFITING INDIVIDUALS</span></strong><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'><o:p></o:p></span></p> <p style='text-align:justify'><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>Likely, President Obama will cite these &quot;early deliverables&quot; as he campaigns for nationwide support for newly enacted health reform.<o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Dependent Coverage</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Section 1001 of the Act requires all group and individual health plans providing dependent coverage to continue providing such coverage for unmarried dependents up to age 26.&nbsp; The Act provides for the promulgation of regulations to define the dependents for whom coverage must be made available.<o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Pre-existing Conditions</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; The Act prohibits health insurance companies from imposing pre-existing condition exclusions on children's coverage.&nbsp; Under Section 1101 of the Act, individuals who are currently uninsurable due to pre-existing conditions will be eligible to enroll in a temporary federally subsidized high risk insurance pool to be established ninety (90) days from enactment, providing such individuals have been uninsured for at least six months prior to the date on which they apply for coverage through the high risk pool.&nbsp; The pool will be available until the health insurance exchanges are operational (January 1, 2014).&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Elimination of Lifetime Limits and other Restriction/Rescission</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Section 1101 of the Act prohibits lifetime limits on the dollar value of benefits/coverage in all group and individual health plans and restricts annual limits on coverage.&nbsp; Health insurance companies may not rescind existing policies as a way to avoid paying for an enrollee's health care.&nbsp; Rescission of benefits is limited to cases of fraud and misrepresentation.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Preventive Care</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; The Act requires new individual and group health plans to cover preventive services without co-pays.&nbsp;&nbsp;&nbsp;<o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Website Support</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Under Section 1103 of the Act, the Secretary of HHS, in consultation with the States, must develop a standard format for presenting health coverage options and must set up a website through which individuals in any State may identify health insurance options meeting their needs.&nbsp; The website would also have information for small businesses concerning coverage options, reinsurance for early retirees, and tax credits.<o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Patient Advocacy Resource</span></u></strong><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>.&nbsp; States must establish an office of health insurance consumer assistance or an ombudsmen program to advocate for patients with private coverage under individual or small group plans.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Crème Filling for the Donut Hole</span></u></strong><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>.&nbsp; Section 1101 of the Reconciliation Act provides for a $250 rebate to Medicare beneficiaries enrolled in Medicare Part D (prescription drug plan) who reach the coverage gap.&nbsp; Currently, the gap falls between $2,700 and $6,154 in total drug costs after which catastrophic coverage kicks in.&nbsp;&nbsp;&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>PROVISIONS APPLICABLE TO BUSINESSES AND EMPLOYERS</span></strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'><o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Small Business Tax Credits</span></u></strong><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>.&nbsp; Tax credits will be provided for qualified small employers for their contributions to purchase health insurance for employees.&nbsp; For tax years 2010 to 2013, a tax credit of up to 35% of the employer's contribution toward the employee's premium will be paid if the employer pays for at least 50% of the total premium cost.&nbsp; Tax-exempt small businesses meeting certain requirements also are eligible for tax credits of up to 25% of the employer's contribution toward the employee's premium.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Early Retiree Reinsurance Program</span></u></strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>.&nbsp; Section 1102 of the Act provides for a new temporary reinsurance program to help businesses providing early retiree (ages 55-64) health benefits, assistance to offset the cost of such coverage.&nbsp; The program would reimburse employers or insurers for 80% of retiree claims between $15,000 and $90,000.&nbsp; The program expires on January 1, 2014.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>HEALTH PROMOTION AND QUALITY MEASURES</span></strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'><o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Wellness Council</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp;&nbsp; The Act establishes the National Prevention, Health Promotion and Public Health Council to coordinate federal prevention, wellness and public health activities and also creates a Prevention and Public Health Fund to facilitate funding for prevention and public health programs.&nbsp; The Act provides for the establishment of task forces and grant programs to foster evidence-based prevention programs and activities, especially in rural areas.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Quality Infrastructure</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; The Act provides resources and financial support to Health and Human Services to develop a national quality strategy and to support quality measures and improvement programs in the federal health care programs.&nbsp; The Act establishes a Patient-Centered Outcomes Research Institute to provide for research comparing the relative effectiveness of health treatments and strategies.&nbsp; Of interest, the comparative effectiveness research may not be used to justify payment and coverage denials.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Investment in New Therapies</span></u></strong><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>.&nbsp; The Act provides for a temporary credit to support investment in new therapies to prevent, diagnose, and treat acute and chronic diseases.&nbsp; The credit is available for &quot;qualifying investments&quot; made in 2009 and 2010.&nbsp;&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>HEALTH CARE WORKFORCE MEASURES</span></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif"; color:#616459'><o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>National Health Care Workforce Commission</span></u></strong><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>.&nbsp; The Act establishes a Commission to provide information and recommendations to Congress and the President regarding current and projected health care workforce needs as well as national health care workforce priorities, goals, and policies.&nbsp; <o:p></o:p></span></p> <p style='text-align:justify'><strong><u><span style='font-size:10.0pt; font-family:"Arial","sans-serif";color:#616459'>Graduation Medical Education (&quot;GME&quot;) Funding</span></u></strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#616459'>.&nbsp; The Act provides for improved flexibility in the laws addressing GME funding to promote training in outpatient settings and also provides for grants to &quot;teaching health centers&quot; for the purpose of establishing new accredited or&nbsp; expanded primary care residency programs.&nbsp;&nbsp;&nbsp;<o:p></o:p></span></p> <p style='text-align:justify'><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>Stay tuned for forthcoming implementation timelines.&nbsp; <o:p></o:p></span></p> <p><strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif"; color:#616459'>Citing Sources</span></strong><span style='font-size: 10.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p><span style='font-size:10.0pt;font-family:"Arial","sans-serif"; color:#616459'>Affordable Health Care for America Implementation Timeline prepared by Committees on Ways &amp; Means, Energy &amp; Commerce, and Education &amp; Labor on March 18, 2010 and available at: </span><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'><a href="http://docs.house.gov/energycommerce/TIMELINE.pdf">http://docs.house.gov/energycommerce/TIMELINE.pdf</a>&nbsp;</span><span style='font-size:13.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p><span style='font-size:10.0pt;font-family:"Arial","sans-serif"; color:#616459'>Side-by-Side Comparison of Major Health Care Reform Proposals-last modified on March 24, 2010 and published by Kaiser Family Foundation and available at:</span><span style='font-size:10.0pt; font-family:"Arial","sans-serif"'> <a href="http://healthreform.kff.org/">http://healthreform.kff.org/</a>&nbsp;</span><span style='font-size:13.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p><span style='font-size:10.0pt;font-family:"Arial","sans-serif"; color:#616459'>H.R. 3590, the Patient Protection and Affordable Care Act found at:</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'> <a href="http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&amp;docid=f:h3590enr.txt.pdf">http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&amp;docid=f:h3590enr.txt.pdf</a>&nbsp;</span><span style='font-size:13.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p><span style='font-size:10.0pt;font-family:"Arial","sans-serif"; color:#616459'>H.R. 4872, the Health Care and Education Reconciliation Act of 2010 found at: </span><span style='font-size:10.0pt;font-family: "Arial","sans-serif"'><a href="http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&amp;docid=f:h4872pcs.txt.pdf">http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&amp;docid=f:h4872pcs.txt.pdf</a></span><span style='font-size:13.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p style='text-align:justify'><span style='font-size:10.0pt;font-family: "Arial","sans-serif";color:#616459'>Visit our Health Law Broadcast at <a href="http://www.hallrender.com/?&amp;section=library&amp;page=broadcast" title="hallrender.com/reform" alias="hallrender.com/reform" conversion=false>hallrender.com/reform</a> for a comprehensive listing of health care reform resources.&nbsp; Also sign up for health care reform alerts and periodic updates as we continue to monitor this important issue.</span><span style='font-size:13.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> </tr> </table> </div> </td> </tr> </table> </div> </td> </tr> <tr style='mso-yfti-irow:4'> <td valign=top style='background:white;padding:0in 0in 0in 0in'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:5'> <td valign=top style='padding:0in 0in 0in 0in'> <p class=MsoNormal align=center style='text-align:center'><span style='mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0 width=555 height=69 id="_x0000_i1025" src="http://www.hallrender.com/email/img/health-law-separator.jpg" alt="http://www.hallrender.com/email/img/health-law-separator.jpg"></span><span style='mso-fareast-font-family:"Times New Roman"'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:6'> <td valign=top style='background:white;padding:0in 0in 0in 0in'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:7'> <td valign=top style='background:white;padding:0in 0in 0in 0in'> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="80%" style='width:80.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padding-alt: 0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width="35%" valign=top style='width:35.0%;padding:0in 0in 0in 5.0pt'> <p class=MsoNormal><strong><span style='font-size:10.0pt;mso-fareast-font-family: "Times New Roman";color:#616459'>Indiana Offices</span></strong><span style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman"; color:#616459'><br> Suite 2000, Box 82064<br> One American Square<br> Indianapolis, IN 46282 <br> (317) 633-4884<o:p></o:p></span></p> </td> <td width="33%" valign=top style='width:33.0%;padding:0in 0in 0in 0in'> <p class=MsoNormal><strong><span style='font-size:10.0pt;mso-fareast-font-family: "Times New Roman";color:#616459'>Michigan Offices</span></strong><span style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman"; color:#616459'><br> Columbia Center, Suite 1200<br> 201 West Big Beaver Road<br> Troy, MI 48084<br> (248) 740-7505<o:p></o:p></span></p> </td> <td width="32%" valign=top style='width:32.0%;padding:0in 0in 0in 0in'> <p class=MsoNormal><strong><span style='font-size:10.0pt;mso-fareast-font-family: "Times New Roman";color:#616459'>Kentucky</span></strong><span style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman"; color:#616459'><br> 614 West Main Street<br> Suite 4000<br> Louisville, KY 40202<br> (502) 568-1890<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1'> <td colspan=3 style='padding:0in 0in 0in 0in'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td width="35%" valign=top style='width:35.0%;padding:0in 0in 0in 5.0pt'> <p class=MsoNormal><span style='font-size:10.0pt;mso-fareast-font-family: "Times New Roman";color:#616459'><br> 8402 Harcourt Road<br> Suite 820<br> Indianapolis, IN 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