With the retirement looming for many physicians, the financial and operational planning for the future of the practice, and the implications for hospital practice, as well, will require several years of planning. Understanding the timing and number of physicians finishing residency programs 3, 4 or 5 years from now, and predicting the retirement of the practice’s physicians, and those on staff and acting as hospital lists, is an important part of the planning practices and hospital administrators need to study.

Most physicians have a pessimistic outlook on the future of medicine, citing eroding autonomy and falling income, a survey of more than 600 doctors found. Six in 10 physicians (62%) said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years, a survey from Deloitte Center for Health Solutions found. 

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Most recently there is an act concerning the expenses relating to the sale of nonprofit hospitals. The Senate and House of Representatives in the General Assembly may contract with experts or consultants to assist in the reviewing the proposed agreement.

Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Subsection (c) of section 19a-486c of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage): (c) The Attorney General may contract with experts or consultants to assist in reviewing the proposed agreement, including, but not limited to, assistance in independently determining the fair market value of the nonprofit hospital's assets. The Attorney General may appoint, or contract with, another person to conduct the review required by this section and make recommendations to the Attorney General. The Attorney General shall submit any bills for such contracts to the purchaser. The purchaser shall pay such bills [within thirty days of] not later than thirty days after receipt. Such bills shall not exceed [three] five hundred thousand dollars. This act shall take effect as follows and shall amend the following sections: Section 1 from passage 19a-486c(c)  

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New Yorkers will see a significant rise in the minimum wage level over the next three years which came as a result of Governor Cuomo’s current $143 billion budget put into effect at the beginning of April. Along with the increases, the budget provides for the Minimum Wage Reimbursement Credit, which was implemented in an effort to subsidize businesses for the increased wage rate.

As of this writing, in May 2013, New York’s current minimum wage level is $7.25/hour, an amount last updated in 2009 when the federal rate was increased to this same amount.  Currently, New York is one of twenty-two states that use the federal rate. Nineteen states currently pay a rate above the federal level.  Cuomo argued that the current rate is too low to support workers and is unable to keep pace with New York’s rising cost of living.  A new hourly rate would help reduce poverty across the state and give a necessary lift to New York’s working class.  

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Overview. On May 2, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule outlining proposed fiscal year (FY) 2014 Medicare payment policies and rates for the inpatient rehabilitation facilities (IRFs) Prospective Payment System (PPS), as well as updates and changes for the IRF Quality Reporting Program (QRP). The FY 2014 proposals are summarized below.

PROPOSED CHANGES TO IRF PAYMENT POLICIES AND RATES:
Updates to the payment rates under the IRF PPS. Based on proposed changes contained within this rule, CMS estimates that aggregate payments to IRFs will increase by $150 million, or 2.0 percent. This estimated increase is attributable to a 1.8 percent payment update, which includes a 2.5 percent market basket increase factor, reduced by a 0.4 percent multi-factor productivity adjustment and an additional 0.3 percentage point reduction as required under the Affordable Care Act. In addition, CMS is proposing an update to the outlier threshold, which would increase IRF PPS payments by an estimated 0.2 percent. 

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The Centers for Medicare & Medicaid Services (CMS) today announced that the application for health coverage has been simplified and significantly shortened. The application for individuals without health insurance has been reduced from twenty-one to three pages, and the application for families is reduce by two-thirds. The consumer friendly forms are much shorter than industry standards for health insurance applications today.

In addition, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options, including plans in the Health Insurance Marketplace, Medicaid, the Children’s Health Insurance Program (CHIP) and tax credits that will help pay for premiums. 

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Prior to the American Taxpayer Relief Act of 2012 (Act), qualified energy facilities needed to be placed in service before January 1, 2014 (or January 1, 2013 in the case of a wind facility) in order to qualify for the Tax Code Section 45 renewable electricity production credit (PTC), or the Section 48 energy investment tax credit (ITC). Under the Act, construction of the facility must simply begin before January 1, 2014 to be eligible to receive the PTC or the ITC. The IRS has issued guidance in Notice 2013-29 for purposes of determining when construction is deemed to begin.

Notice 2013-29 provides two methods that a taxpayer may use to establish that construction of a qualified facility has begun. First, a taxpayer may show that significant physical work has begun. Alternatively, a taxpayer may use a safe harbor method to establish the beginning of construction. 

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The “healthcare crisis”, by whatever name you choose, is likely to be the impetus for some changes in reimbursement going forward. Some may happen soon, some may take more time to be fully formulated and implemented. This article is one of several recently outlining some thoughts on how to change reimbursement. Will your practice or hospital be a net winner or a net loser as these changes go forward? Financial modeling and having a good idea where your costs can be changed, not just buy modicums of decrease but by changing the business model, may allow for better and faster reaction when the changes become more apparent. 

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The friendly economic environment for selling a home came to an abrupt end with the beginning of the recession in 2007. Prior to that, and in most cases, the proceeds from the sale of your home were sufficient for paying off any remaining mortgage debt. This soon became a figment of the past when homeowners engaged with banks in liberal lending practices and assumed debt at a faster pace than the increase in value of their homes. As a result, many homeowners today find themselves burdened with selling their principal residences at a loss and without enough cash to satisfy their mortgage debt. If a lender discharges any portion of the balance of a mortgage, the homeowner must report this as ordinary income. The discharged amount of the mortgage balance is considered to be cancellation of debt income (“COD”) income. Congress recognizing this undue hardship facing taxpayers, quickly responded by enacting the Mortgage Forgiveness Debt Relief Act of 2007 (the “Act”) to provide temporary relief from these unfavorable tax consequences. This article will discuss some of the more common options homeowners have when faced with a variety of these less than favorable situations. 

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A huge pay raise promised under the Affordable Care Act for primary care doctors who treat the nation’s poor covered by Medicaid health insurance is nearly three months behind schedule and may take another three months before it kicks in, state Medicaid directors say. 

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Review of Changes Relating to Health Care Service Provider Payments

The Appropriations and Finance committees of the Connecticut General Assembly released their proposed tax and spending plans for the fiscal years 2014 and 2015 on April 19, 2013. The detailed budget document provides the public with its first look at the extent to which the legislature will implement the two year budget blue print that was presented by Governor Malloy on February 6, 2013. The Appropriations and Finance committees did not make substantial changes the Governor’s proposals. Action on the budget by the full General Assembly is scheduled to be completed by the 2013 Legislative Session end date of June 5, 2013. 

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