Certificates of Need [CON] Questioned in Alabama

Good Health Policy or Competitive Anachronism?

By Staff Writers

Modern Healthcare just reported on a new study by an Alabama policy research group that questions whether the state needs to have a certificate of need process in place to limit the growth of healthcare facilities in the state. 

The API Study 

The study, by the Alabama Policy Institute [API], argued that the state’s CON regulations should be repealed. Its author, Roy Cordato, contended that if the state removes its CON restrictions, doctors, clinics and hospitals would be able to respond to competitive marketplace needs more quickly, which would actually improve the efficiency of healthcare delivery there. 

Methodology

To conduct the study, researchers looked at the experience of other states with CON programs.

Assessment

It found that 13 states have recently repealed CON regulations. Removing CON requirements has given consumers improved access to care in those states. Meanwhile, there’s almost no evidence that Alabama’s existing CON process has helped to reduce healthcare costs. 

Conclusion

And so, are CONs needed for competitive modernity, or are they relics of the misguided political past? 

Related info: www.HealthCareFinancials.com 

More info: The US Healthcare Certificate of Need Sourcebook

www.beardbooks.com/beardbooks/the_us_healthcare_certificate_of_need_sourcebook.html

HO-JFMS-CD-ROM

www.HealthcareFinancials.com 

New Health Insurance Compliance Issues

Implications of US Patriot and Bank Secrecy Acts on Hospitals

By Dr. David E. Marcinko; MBA, CMP™

By Hope R. Hetico; RN, MHA, CMP™  dave-and-hope4

With the recent popularity and growth of personal health insurance plans (PHIPs), health savings accounts (HSAs) and / or medical savings accounts (MSAs), compliance with the USA PATRIOT Act has become an important issue for these new health insurance products.  

These insurance plans place financial services organizations into relationships with shared information institutions like hospitals, healthcare organizations, medical clinics and patient clients.

The Online Connection 

This happens because many, perhaps even the majority of health insurance plans are opened online as patients and insurance company clients use Internet search engines to find the “best” policy type to meet their needs.  

Appropriately, banks, healthcare entities, and hospitals are working with insurance companies, trust companies, banks and broker-dealers to offer identity-compliant and integrated insurance plan products. 

Verifications that these clients are who they say they are, is as paramount as monitoring their activity. 

Example:  

Section 314(b) of the US Patriot Act permits financial institutions and health insurance companies – upon providing notice to the United States Department of the Treasury – to share patient and related information with one another in order to identify and report to the federal government activities that may involve money laundering or terrorist activity.  

The US Patriot Act 

The US Patriot Act aims to partially accomplish this through three critical goals:  

  1. First, it gives investigators familiar tools to use against a new threat.
  2. Second, it breaks down a wall that has prevented information sharing between agencies.
  3. Third, it updates U.S. laws to respond to the current Internet environment.  

Bank Secrecy Act, PHIPs, MSAs and HSAs 

For additional compliance security, The USA Patriot Act also amended the Bank Secrecy Act [BSA] to give the federal government enhanced authority to identify, deter and punish money laundering and related terrorist financing activities.  

Assessment 

Whatever the financial outlays required for insurance/financial organizational compliance, it may result in very large savings later if affected hospital assets and patient health insurance information is safeguarded against attacks of virtual or real assets. 

Conclusion 

And so, what is your opinion on the above health law and policy? 

Institutional information: www.HealthcareFinancials.com 

Terminology: www.HealthDictionarySeries.com 

Related reference: Marc B. Royo and David B. Nash.Sarbanes-Oxley and Not-for-Profit Hospitals: Current Issues and Future Prospects.” American Journal of Medical Quality: Vol. 23, No. 1, 70-72, February 2008.

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Non-Probate [De-facto] Estate Assets

Many Different Assets May Trap Uninformed Doctors

By Lawrence E. Howes; CFP™

By Joel B. Javer; CFP™ 

 

There are situations where avoiding probate is desirable for physicians who want privacy for their finances after their death. And, there are relatively simple ways to avoid probate, but they all have consequences.

Several of these mechanisms are reviewed below: 

[A] Joint Tenancy

Joint tenancy is the conventional way that property between spouses is titled.  Each spouse maintains a 50 percent-undivided interest in the property.  Upon death, the property automatically, by operation of law, passes to the surviving spouse and avoids probate.   However, the automatic aspect of JT means that a will does not control the disposition of the asset.  Before you title anything think about the consequences and be careful when establishing the ownership of all property.   

[B] Community Property

Community property is another form of co-ownership limited to the interests held between husband and wife. Community property does not automatically pass to your spouse. When one spouse dies, the survivor continues to own only his or her half of the assets. The decedent’s will determines the transfer of the other half. Only eight of the 50 states are community-property states, but it is estimated that 25 percent of the population resides in these states. The eight states are Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, and Washington. 

Wisconsin has a form of community property called “marital partnership property.”  The laws of the particular state must be examined to determine the effect on the married couple’s property.  

[C] Life Insurance       

Life insurance is also property.  The two aspects of the property are the face amount and unless it is a term life insurance policy, the cash value. 

The critical item to remember is: if you own the policy, then the face amount or death benefit is included in your estate and probably subject to estate taxes.  The death benefit passes through the operation of a beneficiary designation.  At the time of death most cash value policies include the existing cash value in the death benefit. This is known as a type A policy. Type B excludes the cash value from the death benefit so it would be added to the face amount.        

[D] Retirement plans

Your retirement plans and IRAs are transferred by beneficiary designation.  It is common to see a physician who is divorced still have an ex-spouse as the named beneficiary on a retirement plan or life insurance policy. Making sure that all beneficiary designations are consistent with your current estate plan will avoid these unintended consequences. 

[E] Revocable Living Trust

In a revocable living trust your assets are voluntarily placed in a trust thereby making you a trustor.  The control of the assets in the trust is then transferred to a trustee.  You can make yourself the trustee as well. 

The key word here is revocable, which means the terms of the trust can be changed, altered, amended or terminated. Legal title to the property however is retained by the trust. The trust can provide continuity of investment management, bill paying, collection of accounts receivable and general financial stability until the medical professional is able to resume control of his or her financial affairs.  

In addition, if property is owned in more than one state, ownership of that property by a revocable living trust would eliminate the necessity of dealing with probate in several states. 

[F] Buy-Sell Agreements 

A highly valued medical practice may not have sufficient cash to buy out a deceased partner and face an overwhelming financial burden. Life insurance is commonly considered the best vehicle to provide the cash when it is needed the most, and there several different way to create a practice buy-sell agreement.

Nevertheless, always remember that it too, is an asset. 

Conclusion:

What is your experience with any of the above non-probate assets in your estate planning endeavors? 

More information: http://www.jbpub.com/catalog/9780763733421/

Linuistic terms:  www.HealthDictionarySeries.com

 

Non-Profit Hospitals and CEO Salary

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The Connecticut State Challenge

[By Staff Writers]Doctor Scrubs

The state of Connecticut has 31 hospitals that are economically struggling.

The Report 

In fact, according to a 2006 report – led by Governor M. Jodi Rell – more than half of the state’s non-profit hospitals ran deficits while the rest generated below-adequate surpluses. Financial help has been slow from the state’s insurance programs. 

The Findings 

And so, the question raised by the state task force was whether these same hospitals should be paying CXOs steadily increasing salaries?

Examples: 

  • Salaries paid to top CEOs at the state’s hospitals grew 95 percent between 2002 and 2006, with some topping $1 million.
  • Hartford Hospital President and CEO John Meehan made just over $1 million in 2006, up 27 percent from 2002.
  • The salary of Robert Kiely, CEO of Middlesex Hospital in Middletown, climbed 82 percent, from $511,220 in 2002 to $932,923. 

Assessment 

In their defense, the hospitals stated they must compete with national salary levels to recruit top talent. And so, what is your opinion on the matter; is there a dichotomy between medical-mission and personal profit-margin?

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 

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Addictive Investing Personality of Medical Professionals

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“The Addictive Investing Personality of Medical Professionals and Related Compulsions”

An exclusive white-paper report on medical professionals and their investing compulsions by one of the nation’s leading psychologists, gambling addiction and trauma specialists. 

AUTHORS:

Eugene Schmuckler PhD MBA MEd CTS [Behavioral Psychologist]

David Edward Marcinko CMP MBA MBBS

POSITION: Academic Dean: www.CertifiedMedicalPlanner.org an online certification program with fiduciary trademark logo that teaches financial professionals about contemporary health economics, physician focused financial planning, medical business management and related topics of organizational modernity.

cmp-logo16

http://www.CertifiedMedicalPlanner.org

TOPIC: The Addictive Investing Personality of Medical Professionals and Related Compulsions

EXERPT: Hard-working physicians and other medical practitioners confronted with the problems associated with managed care and healthcare reform may very well choose to direct a portion of their energies to “playing the market.” It is legal and ethical and offers the opportunity of quickly increasing one’s personal wealth – or NOT.  

Functioning virtually alone prevents others from questioning their actions. While not directly equivalent, this action is akin to the drinker who drinks alone so that no one really knows just how much is consumed – a recipe for financial and emotional disaster.”

Speaker: If you need a moderator or a speaker for an upcoming event, Dr. Gene Schmuckler is available for speaking engagements. Contact him at: MarcinkoAdvisors@msn.com

***

READ WHITE PAPER:

addictive-investing.pdf

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

***

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http://www.BusinessofMedicalPractice.com

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Health Plans Draws Fire for Physician Incentives

Doctors May Profit from Generic Drug Switch

Staff Writers 

Several of the nation’s health plans are drawing scrutiny for offering financial incentives to entice doctors to prescribe cheaper generic medicines; according to a recent report from the Wall Street Journal.

This practice includes paying them up to $100 each time they switch a patient from a brand-name drug to a generic equivalent. 

As some pharmaceutical patents for a growing number of blockbuster drugs expire, some health insurers are using doctor-bonuses for writing more generic prescriptions. 

Proponents argue that the goal of saving patients, employers and insurers money is a noteworthy one. Others argue that it is only justified to reimburse doctors for spending time evaluating patients to determine whether a cheaper generic alternative is better – not for paying them for a wholesale switch. 

But aggressive approaches, like cash-rewards for each patient switched from a given list of drugs, are coming under fire for injecting financial incentives into what should be a purely medical decision. 

And, some medical societies are concerned that rewards may put doctors in the ethically questionable position of taking payments that patients know nothing about. 

Conclusion: And so, what are your thoughts on the matter?

Lexicon: www.HealthDictionarySeries.com