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MacKenzie Hughes attorneys discuss health law’s effect on providers
SYRACUSE — Health-care providers have major concerns about how the national health-care reform law, called the Affordable Care Act or Obamacare, will affect them, according to two attorneys with the Syracuse–based law firm Mackenzie Hughes, LLP. Physicians are concerned that the health law will reduce their freedom in how they practice medicine due to all […]
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SYRACUSE — Health-care providers have major concerns about how the national health-care reform law, called the Affordable Care Act or Obamacare, will affect them, according to two attorneys with the Syracuse–based law firm Mackenzie Hughes, LLP.
Physicians are concerned that the health law will reduce their freedom in how they practice medicine due to all the regulations governing what procedures they can use, says Clayton Hale, Jr., an attorney with Mackenzie Hughes, LLP.
Hale concentrates his practice in the areas of health care, business, and tax law, according to the firm’s website.
“It’s going to provide them with more work because they’ll have more patients if they choose to participate in the Medicare and Medicaid programs, but also the paperwork is going to require a lot of additional hours in the work day,” Hale says.
Hale also believes doctors are concerned that they won’t be generating as much revenue under the health-care law because of reduced reimbursements.
Physicians also need to determine if it makes sense to become a participating provider with one, or any, of the health-care plans that are part of the state or federal health-insurance exchanges, says Maureen Dunn McGlynn, an attorney and partner in the Mackenzie Hughes firm’s business department with an emphasis in health-care law.
Doctors have to realize that participating in new plans will mean “the additional required quality data collections and reporting that’s required in order to be a participating provider with these plans that are part of the exchanges,” McGlynn says.
Hale then provided some examples of the requirements health-care providers will face in 2015.
A physician will have to demonstrate that he or she is using the best clinical practices so that a health insurer will permit the doctor to participate in a given plan, Hale says.
In addition, doctors have to demonstrate the use of chronic-disease management procedures and the use of evidence-based medicine.
“They also have to participate in the health-information technology rules. They have to convert from paper-based records to digitized records,” Hale says.
Those requirements are detailed in the law, but Hale wasn’t sure when the federal government would release the regulations detailing those requirements.
McGlynn also notes the federal health-care reform law has led to the creation of accountable-care organizations (ACO).
Such an organization enables various providers (physicians, hospitals, physician groups) to join together to provide care for patients. If the group is able to save money, then the providers within that ACO share in the federal government’s incentive payments for proving that their collaboration resulted in quality care at a lower cost, McGlynn says.
The health-care reform law covers a wide range of medical issues, but one matter it doesn’t address is their liability for malpractice, Hale says.
It’s been an issue for doctors for several years, and Hale think it’ll become an “even bigger problem” as the Affordable Care Act is requiring doctors to “economize” in the way they practice medicine, such as reducing the number of tests they perform.
“So if a doctor doesn’t perform the test because he’s being pressured not to run up costs, and he makes a mistake, or he should’ve done the test, they’re still liable for substantial damages in the malpractice area,” Hale says.
The law also doesn’t address the “doc fix,” which relates to the formula for Medicare reimbursement, according to Hale.
For more than a decade, Congress has had to approve a bill to prevent scheduled cuts to Medicare-physician payments, or what is known as the “doc fix.”
“[Lawmakers will] have to do that again at the end of this year; otherwise, there’ll be a substantial reduction in the reimbursement rate next year,” Hale says.
Contact Reinhardt at ereinhardt@cnybj.com
New York State Bar Association launches new Women’s Community
The New York State Bar Association (NYSBA) announced it has created a new initiative to meet the unique challenges faced by women attorneys. The NYSBA Women’s Community launched on Oct. 17 at the Committee on Women in the Law’s program, “Women on the Move 2013: Racing Ahead of the Curve – Tech-Savvy Practice Pointers for
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The New York State Bar Association (NYSBA) announced it has created a new initiative to meet the unique challenges faced by women attorneys.
The NYSBA Women’s Community launched on Oct. 17 at the Committee on Women in the Law’s program, “Women on the Move 2013: Racing Ahead of the Curve – Tech-Savvy Practice Pointers for Innovative Women Attorneys,” at the State Bar Center in Albany.
“Women represent nearly half of all law students, yet constitute just 20 percent of law firm partners. Even in high-level positions, women make significantly less than their male counterparts do,” New York State Bar President David M. Schraver, a partner with the Rochester law firm Nixon Peabody, said in a news release. “We developed the Women’s Community to help connect women attorneys with the State Bar and each other for professional success.”
The newsletter, “NYSBA Women’s Community,” includes practical tips for career success, updates from NYSBA staff, and interviews with prominent attorneys, according to the release. The NYSBA’s recently unveiled website features an online resource center, www.nysba.org/womenscommunity. It also offers online professional-development resources, links of interest, and a private online community, according to the NYSBA.
The 76,000-member New York State Bar Association says it’s the largest voluntary state bar association in the nation. It was founded in 1876.
The real story: the public is the problem
Late in the evening of Wednesday, Oct. 16, President Barack Obama signed legislation to re-open the federal government, which had been partially shut for 16 days. The political drama captured the attention of the media, which was consumed by the tactical struggle and the question of who won and who lost. The real story occurred
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Late in the evening of Wednesday, Oct. 16, President Barack Obama signed legislation to re-open the federal government, which had been partially shut for 16 days. The political drama captured the attention of the media, which was consumed by the tactical struggle and the question of who won and who lost.
The real story occurred on Friday, Oct. 18, at 3 p.m. when the Treasury announced that the federal debt exceeded $17 trillion. Every U.S. citizen now has a debt obligation approaching $54,000 as the federal government continues unabatedly to borrow $200 million an hour.
Surpassing the $17 trillion debt mark was just the introduction to the story that should have dominated the media. The history of how we got here would then follow. It took the U.S. government 193 years to rack up the first trillion dollars; eight years later, in 1990, the number jumped to $3 trillion. When George W. Bush took office in 2001, the debt was $5.7 trillion. President Bush only needed two terms in office to balloon the debt to $10 trillion. Not to be outdone, President Obama has increased the debt 70 percent in less than six years and is on target to reach the 100 percent mark ($20 trillion) when he leaves office.
The real story would end by addressing what drives spending and the resulting deficits and debt — “entitlements.”
Robert J. Samuelson, in an Oct. 20 op-ed piece in The Washington Post, suggests we banish the term entitlements and identify specific programs in order to evaluate them. Here is the Top 10 list, brought to you by the Office of Management and Budget, and ranked by the millions of recipients in the program: Medicaid – 63.2, Social Security – 55.8, Medicare – 49.9, Food stamps – 46.6, Child nutrition – 35, College loans – 11.3, Unemployment insurance – 8.9, Supplemental Security Income – 7.9, Veterans compensation – 3.8, Civil-service retirement – 2.5.
If we eliminate the overlap in some of the programs where recipients receive multiple benefits, that still leaves about half of all U.S. households receiving a federal benefit. That’s a huge constituency. In 2012, all of the entitlement programs accounted for 63 percent of total federal expenditures.
Samuelson also suggests that we get rid of the word entitlement because it deludes the public into thinking the programs are untouchable. If truth be told, these programs have no legal standing. The U.S. Supreme Court dealt with this issue as early as 1937 (Helvering v. Davis) when the court ruled that Social Security was not a contributory insurance program but a payroll tax for a welfare system. Our 535 elected politicians in Congress can alter the terms of Social Security or any other federal program on a whim. In 1960, the Supreme Court confirmed the status of Social Security, and thus all other federal programs, in Fleming v. Nestor, when the court proclaimed that Social Security benefits were not “accrued property rights.”
The polls keep telling us that the public has a limited willingness to be taxed and instinctively understands that we can’t keep spending and borrowing at the current rate. At some point, interest rates will rise and the $223 billion in interest we currently spend annually to sustain our borrowing addiction will rise and squeeze out other spending options and reduce investment available to private capital markets. At some point, our creditors will become disenchanted, since their “investments” are being repaid in depreciated dollars that the feds print ‘round the clock. Worst-case scenario, our monetary system collapses.
But the same polls tell us that 90 percent of our fellow citizens don’t want Uncle Sam to mess with “their benefits.”
America, you can’t have it both ways. In the 1970s, the U.S. was the world’s biggest creditor. Today, we’re the biggest debtor on the globe. The answer is to modify benefits and eligibility levels over time so as not to distort the economy and also to make the changes politically acceptable. Blaming the Beltway for gridlock is an easy distraction from the real problem.
The story will end well when Americans finally look in the mirror to identify the real problem and admit that all they are doing is passing a heavy financial burden on to our children and grandchildren so that we can continue our current bi-polar lifestyle. Washington will respond when the public finally makes up its mind to embrace fiscal sanity.
Norman Poltenson is publisher of The Central New York Business Journal. Contact him at npoltenson@cnybj.com
Tax Benefits for Hiring Targeted Groups
The Work Opportunity Tax Credit (WOTC) is a valuable tax break for businesses that hire workers from certain targeted groups. Although it has been available in some form for many years, it tends to be overlooked. Currently, the WOTC is available only for businesses that hire employees that begin work before Jan. 1, 2014. Although
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The Work Opportunity Tax Credit (WOTC) is a valuable tax break for businesses that hire workers from certain targeted groups. Although it has been available in some form for many years, it tends to be overlooked. Currently, the WOTC is available only for businesses that hire employees that begin work before Jan. 1, 2014. Although it may be extended, taking advantage of it now will ensure that your business benefits no matter what Congress decides.
Simply stated, the WOTC provides a tax credit to employers who hire members of certain targeted groups. The credit is worth 40 percent of first-year wages up to a maximum amount. Depending on the classification of the employee, the maximum credit can range from $2,400 to $9,600. The greatest tax benefits are provided to employers who hire long-term, family-assistance recipients, or veterans with a service-connected disability who have aggregate periods of unemployment of six months or more in the 12-month period ending on the date of hire.
Legislation passed in 2011 expanded the WOTC to include liberalized rules for a number of other groups of qualifying veterans, including those who are a member of a family receiving assistance under the Supplemental Nutrition Assistance Program (SNAP or food stamps) for at least three months in the 15 months prior to hiring, those unemployed for aggregate periods totaling at least four weeks in the 12 months prior to hiring, and those with a service-connected disability hired not more than one year after being discharged or released from active duty.
Other targeted groups include qualified recipients of temporary assistance to needy families, qualified ex-felons hired no later than one year after conviction or release from prison, designated community residents age 18 through 39, vocational rehabilitation referrals, qualified SNAP recipients age 18 through 39, and qualified Supplemental Security Income (SSI) recipients. There is also a more limited credit for designated summer youth employees age 16-17.
To be eligible for the WOTC, a new employee must be certified as a member of a targeted group by a State Employment Security Agency (SESA). You must receive the certification by the day the employee begins work or complete a pre-screening notice and certification request on or before the day you offer the individual a job and submit it to the SESA within 28 days after the employee begins work. Since the process is somewhat involved, you should start early to have your employees certified before year-end.
Tax-exempt organizations can also claim a payroll-tax credit, subject to certain limits, for hiring qualifying veterans. If you are considering hiring WOTC-eligible individuals, you should consult your tax adviser for the specific benefits available to you and the process you should follow to ensure that you receive the maximum benefit.
Eileen C. Semmler, CPA is a tax partner in the Small Business Advisory Group of The Bonodio Group.
Do You Accept Soft Corruption?
Here is a piece of corruption that is all too common among politicians. The guy who is about to be elected the next mayor of the Big Apple, Bill de Blasio, was formerly a Brooklyn city councilman. Sometime around 2005, his wife, Chirlane McCray, was looking for a job. So, he introduced her to the
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Here is a piece of corruption that is all too common among politicians.
The guy who is about to be elected the next mayor of the Big Apple, Bill de Blasio, was formerly a Brooklyn city councilman. Sometime around 2005, his wife, Chirlane McCray, was looking for a job. So, he introduced her to the CEO of a hospital in his district.
On the city council, de Blasio had pushed for millions of taxpayer bucks for the hospital, Maimonides Medical Center. The hospital had good reason to be grateful to him. It had reason to believe it might be punished if it did not find her a job.
But, Maimonides had no job open. So, it created one — just for the councilman’s wife. Funny that. Because various city hospitals have found many jobs for wives and friends and relatives of politicians. These happen to be politicians who stream millions of dollars to the hospitals. It’s all just a coincidence, of course.
Such was the work of Hillary Rodham Clinton at a Little Rock law firm. She got the job because she was the governor’s wife. And, the firm got lots of work as a result.
Michelle Obama landed a fat job with few qualifications, at the University of Chicago Medical Center — while her husband served in a powerful political position.
If you pry, you will find thousands of these jobs all over this state and nation. They are the fruits of soft corruption. The type of corruption too many of us accept. We just shrug and say, “What’s new? Politicians have always done this stuff.”
Are these no-show jobs? Some of them. Are they nudge and wink jobs? Jobs that pay $300,000 for $50,000 worth of work? Often.
Are they “If you know what’s good for you…” jobs? That is, if you want the tax money to keep flowing your way, you had better find a job for my wife/pal/nephew. Yes, many of them are such positions.
When Monica Lewinsky held a razor to Bill Clinton’s political throat? His pal Vernon Jordan hit up some big companies to find a big job for the temptress. To shut her up. Companies responded rather than risk the back of the hand of the president.
So, you shrug this off. You say it doesn’t hurt you in any way. Maybe it doesn’t. And maybe it does.
How many bucks — your tax dollars — get wasted this way? How many millions are shoveled to projects only because somebody needs to be rewarded? How many legitimate candidates lose out on jobs because they have no connections to elite political figures?
Meanwhile, how much do the inefficiencies cost? Those that come from unqualified people filling jobs they screw up.
We cannot know. But we cannot deny that this corruption carries a price tag.
It also breeds cynicism among those who work under such appointees. And among those who know about this stuff and never bother to apply for jobs — because they know the game is rigged.
It breeds a cynicism among voters. They lose faith in a system that allows and encourages this stuff. They come to believe that one hand washing the other leaves both hands filthy. In Albany. In city and town governments. In Washington, DC.
If enough of us dwell on stuff like this, we could come up with a new dance. C’mon, everybody, let’s Shrug! During the dance, somebody picks your pocket.
From Tom…as in Morgan.
Tom Morgan writes about political, financial, and other subjects from his home near Oneonta, in addition to his radio shows and new TV show. For more information about him, visit his website at www.tomasinmorgan.com
Kionix CEO and co-founder Galvin resigns
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