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DATE: TUESDAY, APRIL 1, 2014 8:00 AM EDT

TODAY’S EDITION

AHCA/NCAL in the News Medicare News Washington Health Care Association Branch Awards Senate Approves Medicare Payment Patch Legislation...... 6 “Outstanding Work” In The Industry...... 1 Senate Approves Bill To Reduce Payments To Doctors For Affordable Care Act/Health Reform Implementation Certain Medical Procedures...... 7 ACA Enrollment Nears Seven Million As Deadline Spurs Cardiac Rehab Programs Now Covered By Medicare...... 7 Interest, Hobbles Website...... 1 Blog: Journalists Overlooking Protecting Access To Medicare States See Surge In Interest, Technical Problems As Open Act Of 2014...... 7 Enrollment Ends...... 3 Industry News Sebelius Discusses ACA As Open Enrollment Draws To A American Heart, Stroke Associations Release Stroke Survivor Close...... 4 Care Recommendations...... 7 Poll: Support For ACA Climbs To 49%...... 5 Expert Panel Releases Recommendations...... 7 Supreme Court Turns Away Early Look At Additional NYTimes Reviews Book About Caregiving...... 7 Contraceptive Mandate Challenge...... 5 CEO: ARIA, GROWTH Keys To Success...... 8 Medicaid Expansion Proponents Continue Push...... 5 Family Caregiver Trend Impacting Individuals, National Connecticut Offering “Exchange In A Box.” ...... 6 Workforce...... 8 New Hampshire Uninsured Face More Coverage Options Senior Center Residents Join Program To Make Dolls For Under ACA...... 6 Disabled Children...... 8 Volunteers Canvassing For ACA Arrested In Chicago...... 6 Half Of ACA Subsidy Recipients Projected To Become Ineligible Assisted Living News Within 12 Months...... 6 Assisted Living Concepts “Rebrands” To Reinvigorate Image. .... 8 Commentary Considers ACA As Open Enrollment Period Ends. 6 Developer Plans To Construct Second, Third California Senior Living Facilities...... 8

AHCA/NCAL IN THE NEWS AFFORDABLE CARE ACT/HEALTH Washington Health Care Association Branch REFORM IMPLEMENTATION Awards “Outstanding Work” In The Industry. ACA Enrollment Nears Seven Million As The Spokane (WA) Spokesman-Review (4/1, Curless, 208K) reports 2014 marks the first year the Washington Health Care Deadline Spurs Interest, Hobbles Website. The Association’s Eastern Washington chapter is honoring Affordable Care Act’s first open-enrollment period came to an “outstanding work” in the industry by presenting care awards. official close at midnight. And while people in most states will According to WHCA’s Brenda Orffer, “The point of these be able to sign up for coverage under the law for a bit longer, awards is to highlight and honor them for the sometimes the date was still hailed as a milestone in several front-page thankless job these people do. They are not working a job. stories, news broadcasts, and across the web. The coverage They are answering a call.” generally focuses on the high volume of applicants the day saw, which both bumped up enrollment figures and caused the main portal, healthcare.gov, to malfunction. On its front page, USA Today (4/1, A1, O'Donnell, morning due to a software bug, and again this afternoon Madhani, Locker, 5.82M) reports that late Monday, a preventing new applicants from logging in.” “government official” said that the Administration believes it On ABC World News (3/31, story 2, 2:10, Sawyer, “is on track to sign up 7 million people by the midnight 7.43M), correspondent Jon Karl reported that there are “still deadline.” Still, the article acknowledges “it is likely to be glitches” hampering healthcare.gov, which was “down for weeks before there is a final tally of how many people signed hours” on Monday. Karl also reported that “many questions up for insurance” during the law’s first enrollment period. An are still unanswered, including how many people have AP (4/1, Alonso-Zaldivar, Lederman) report carried widely actually paid to enroll,” and “how many of those who have also says the law is “on track” for seven million sign-ups. signed up have actually paid?” In a front-page story titled “New Technical Woes On the CBS Evening News (3/31, story 3, 1:15, Pelley, Hobble Health-Insurance Sign-Ups At Zero Hour,” the Wall 5.58M), Scott Pelley reported that the Administration once Street Journal (4/1, A1, Ante, Radnofsky, Subscription “expected seven million would sign up by today,” and Publication, 4.25M) hones in on the website’s troubles, noting President Obama now anticipates that the total will be “just that the online marketplace was down for several hours, short of that.” CBS also played a clip of the President preventing some people from creating accounts and others detailing the progress that has been made in regards to the from signing in. And while Monday saw over 200,000 ACA’s implementation from an interview the President sat for applications started as of 5:00 pm, the article points out that with Pelley last week. this high interest led the error rate for pages on to More Coverage. Cable television programs covering skyrocket. the last day of open enrollment were Bloomberg TV’s In its front-page story, titled “HealthCare.gov Hiccups Bloomberg West (3/31, 11:11 p.m. EDT), ’ The Amid Deadline-Day Frenzy,” the Washington Post (4/1, A1, O’Reilly Factor (3/31, 11:01 p.m. EDT, 2.53M), Fox News’ Goldstein, Sun, 2.33M) reports that the site’s troubles came Special Report, Fox Business’ Lou Dobbs Tonight (3/31, 7:33 as “Americans around the country are racing to sign up for p.m. EDT, 49K), MSNBC’s The Ed Show (3/31, 449K), health plans before a midnight deadline.” Around noon, for MSNBC’s (3/31), and MSNBC’s example, new visitors were “greeted with a screen saying, The Last Word with Lawrence O’Donnell (3/31, 984K). ‘We need you to wait here, so we can make sure there’s Several other print and online outlets released accounts room for you to have a good experience on our site.’” of healthcare.gov’s troubles throughout the day, including the In a front-page analysis, the New York Times (4/1, A1, Wall Street Journal (4/1, Ante, Subscription Publication, Pear, Subscription Publication, 5.41M) reports that the White 4.25M) website, the New York Times (4/1, Joachim, House “embarked on a kind of victory lap” Monday, with Subscription Publication, 5.41M), the Los Angeles Times (4/1, “Administration officials” appearing “confident that they would Levey, 2.38M), the Washington Post (4/1, Eilperin, 2.33M) reach their original goal of having seven million people sign “Post Politics” blog, the Washington Times (4/1, Howell, up for private health plans.” The Los Angeles Times (4/1, 230K), another from the Washington Times (4/1, Howell, Reston, 2.38M) adds that “longtime Obama allies in 230K), Bloomberg News (4/1, Chen, 392K), Reuters (4/1, Hollywood and the music industry, including John Legend, Morgan), The Hill (4/1, Easley, 76K) “Healthwatch” blog, Kerry Washington, Connie Britton, Zooey Deschanel and TIME (4/1, Alter, 23.62M), the NPR (4/1, Rovner, 260K) Sarah Silverman took to Twitter” to urge their followers to “Shots” blog, The Wrap (4/1, Crugnale, 137K), CQ (4/1, seek coverage via the ACA exchanges. The Times reports Reichard, Subscription Publication, 967), FOX News (4/1, that also on Monday, Planned Parenthood “said its 600 74.23M), the Huffington Post (4/1, Young, 11.54M), Politico, canvassers had been knocking on an average of 29,000 Variety (4/1, Johnson, 4.98M), PBS’ NewsHour (4/1, doors a day, armed with tablets that allowed families to Woodruff, 90K), another from PBS’ NewsHour (4/1, complete their applications online right then.” Montanaro, Burlij, 90K), The Guardian (4/1, Kasperkevic, The network nightly news broadcasts dedicated over 1.59M), Kaiser Health News (4/1, Platt, 2K), The Hill (4/1, eight minutes of airtime to the Affordable Care Act, focusing Viebeck, 76K) “Healthwatch” blog, CNBC (4/1, Mangan, on both the spike in interest and the troubles it caused for the 29.84M), and CNN (4/1, Luhby, 67.19M). website. Additional coverage of the last official day of open On NBC Nightly News (3/31, story 5, 2:25, Williams, enrollment is offered by the AP (4/1), Bloomberg News (4/1, 7.86M), Brian Williams reported that “with the last minute Wayne, 392K), a second piece in Bloomberg News (4/1, surge and people rushing to beat the clock today came new Wayne, 392K), the AP (4/1), the Washington Post (4/1, Fuller, glitches with the website.” Peter Alexander went on to report 2.33M) “The Fix” blog, the Washington Post (4/1, Millman, that “for a while today it seemed like the healthcare.gov 2.33M) “Wonkblog,” the Washington Post (4/1, McKellogg, website may finish the way it started – offline briefly this 2.33M) “Reliable Source” blog, the Washington Post (4/1, Wemple, 2.33M) “Wemple” blog, the USA Today (4/1, Singer, 2 5.82M) “On Politics” blog, TIME (4/1, Hirschhorn, 23.62M), The Miami Herald (4/1, Chang, Borns, 667K) reports CBS News (4/1, Condon, 1.32M), the Chicago Sun-Times that HHS has reported that “of the more than 6 million (4/1, Terman, 992K), the NPR (4/1, Halloran, 260K) “It’s All Americans who selected health plans through February, more Politics” blog, CBS News (4/1, Condon, 1.32M), CNBC (4/1, than 440,000 were Floridians — exceeding every other state Mangan, 29.84M), The Hill (4/1, Viebeck, 76K) “Healthwatch” relying on the federally-run insurance exchange” – and “an blog, The Hill (4/1, Sink, 76K) “Blog Briefing Room,” another additional 125,000 Floridians were assessed eligible for post in The Hill (4/1, Sink, 76K) “Healthwatch” blog, CQ (4/1, Medicaid.” Adams, Subscription Publication, 967), McClatchy, the Politico (3/31, Haberkorn, 73K) reported that the state Christian Science Monitor (4/1, Trumbull, 384K), and BBC of Washington “had enrolled more than a half-million people News (4/1, 348K). as of March 20 — more than 125,000 of whom who got private insurance coverage in the exchange, (plus another States See Surge In Interest, Technical 66,000 who have chosen a plan but not yet paid) and about Problems As Open Enrollment Ends. With the 380,000 newly enrolled in Medicaid.” Affordable Care Act’s first open enrollment period officially The Milwaukee Journal Sentinel (4/1, Boulton, 604K) ending Monday night, states, both those using healthcare.gov reports that “through February, 71,443 people in Wisconsin and those running their own exchanges, performed a last- had picked a health plan sold on the federal marketplace, minute push to increase enrollment in spite of persistent with 90% of them eligible for subsidized coverage,” while “an technical problems. additional 68,655 people were found to be eligible for In California, the Los Angeles Times (4/1, Terhune, BadgerCare Plus, the state’s largest Medicaid program.” Karlamangla, 2.38M) reports that Covered California was In Hawaii, the AP (4/1, Bussewitz) reports “exchange “prevent[ing] some consumers from finishing their officials pushed to enroll as many people as possible Obamacare enrollment so others could start the sign-up Monday.” process to meet Monday’s deadline.” While noting the In Colorado, the AP (4/1, Wyatt) reports that consumers process was not ideal, exchange director Peter Lee said in the state were also hurrying to enroll in health coverage. people who started their applications would have extra time to The Denver Post (4/1, Draper, 770K) and the Boulder (CO) enroll. Southern California Public Radio (3/31, Glickman, Daily Camera (4/1, Byars, 112K) also report on last-minute 57K) reports that the website change became necessary enrollment in Colorado. because web traffic was “threatening to overwhelm Covered In Massachusetts, the Lowell (MA) Sun (4/1, Diana, California’s website.” Several other outlets report on the 142K) reports on the state’s exchange in a story titled website’s denial of service to some users, including Inside “Confusion reigns at Health Connector site.” Massachusetts Bay Area (CA) (4/1, Seipel, 12K), Southern California Public consumers have had difficulty navigating the website and Radio (3/31, O'Neill, 57K), and U-T San Diego (3/31, Sisson, determining if they have health insurance coverage. The Fall 611K). River (MA) Herald News (3/31, 116K) reports on concerns In Minnesota, the Minneapolis Star Tribune (4/1, about the security of the Health Connector website. The AP Crosby, Dullinger, 947K) reports that the last day of open (4/1, Leblanc) and NBC News (4/1, Fox, 950K) also report on enrollment resulted in “long wait times at the state’s MNsure the state exchange. call center and a bogged-down website that prevented some In Oregon, the Eugene (OR) Register-Guard (4/1, people from completing enrollment.” Wozniacka, 172K) reports that “uninsured Oregonians have In Connecticut, the New London (CT) Day (3/31, 76K) an extra month to sign up because of the state exchange’s reports that, due to an overwhelmed website, consumers technology problems.” Residents now have until April 30 to were encouraged to sign up over the phone “and leave their apply for insurance coverage and the state is launching a name, address and phone number in a secure voice mail new ad campaign to boost enrollment. The Oregonian (4/1, message.” Budnick, 819K) reports that the exchange announced it will In Louisiana, the AP (4/1, Mcgill) reports that problems no longer make its oversight meetings secret. Another story with healthcare.gov slowed insurance signups yesterday. in The Oregonian (4/1, Budnick, 819K) reports that Aaron In Maryland, the Washington Post (4/1, Wagner, 2.33M) Karjala, chief information officer for the exchange, announced reports that the state’s health insurance exchange has his resignation following highly publicized problems with the become a major issue in the campaign for governor. exchange. In Kentucky, the Louisville (KY) Courier-Journal (3/31, In Rhode Island, the AP (4/1, Niedowski) reports that Kenning, 422K) reports that Kynect “saw few of the last-day the director of HealthSource RI touted the exchange. glitches that stymied sign-ups on the federal website.” Christine Ferguson referred to it as “the envy of the rest of the country and the federal government.” The Providence (RI)

3 Journal (3/31, Niedowski, 328K) also reports on Ferguson’s Another aspect of Sebelius’ interview with KWTV-TV comments. generated some interest. As CBS News (3/31, 1.32M) put it, In Vermont, the AP (3/31) reports that consumers were she appeared “speechless” after the station’s anchor pointed rapidly signing up for coverage up until the deadline, with out the law’s “unpopularity” in Oklahoma. Also reporting on 2,600 Vermonters enrolled over the weekend. The Burlington this particular interview are The Hill (4/1, Easley, 76K) (VT) Free Press (3/31, 116K) also reports on the exchange. “Healthwatch” blog, McClatchy (4/1, Pugh, Subscription In Washington, the Seattle Times (3/31, Marshall, Publication, 13K), the Daily Caller (3/31, May, 135K), the 834K) reports that the website for Washington Washington (DC) Post (4/1, Blake, 2.33M) “Post Politics” Healthplanfinder experienced downtime that may have been blog, FOX News (4/1, 74.23M), another piece from FOX related to service outages at healthcare.gov. Another Seattle News (3/31, 74.23M), Gawker (4/1, 392K), the Examiner (4/1, Times (3/31, Marshall, 834K) story also covered the Newby, 1.05M), and the Washington (DC) Free Beacon (4/1, exchange. 79K). In Maine, the Waterville (ME) Morning Sentinel (4/1, Sebelius gave interviews to several other local Miller, 59K) reports that navigators were experiencing “a television stations, including WLWT-TV Cincinnati (3/31, 6:14 surge of calls and appointments” yesterday from people trying p.m. EDT, 76K), WBNS-TV Columbus, OH (3/31, 5:33 p.m. to beat the deadline. In Florida, the Sarasota (FL) Herald- EDT, 112K), KDFW-TV Dallas (3/31, 88K), KTAL-TV Tribune (4/1, White, Hackett, 170K) reports that the state is Shreveport, LA (3/31, 711), and WJW-TV Cleveland (3/31, “one of the Affordable Care Act’s biggest success stories.” 103K). The state has enrolled more than 440,000 people, which is MSNBC (4/1, Whitaker, 45.1M) reports that Sebelius far more than the initial target of 381,600. also spoke with HuffPost Live on Monday, defending the In Indiana, the AP (4/1, LoBianco) reports that the state Administration against claims they are “cooking the books” saw a “crush of health insurance applicants” on the final day with ACA figures. She said, “I think it’s unfortunate that again of the enrollment period. The Indianapolis Star (3/31, people who are not very enthusiastic about having the law Berggoetz, 515K) also reports from the Hoosier state. work, haven’t done any outreach to their constituents, haven’t In Nebraska, the AP (4/1) reports that “Nebraskans given accurate information, are now suggesting that the raced to beat the insurance enrollment deadline” as problems enormous interest in enrolling for health care is not existing.” with healthcare.gov held back many of their efforts. Additional coverage of this interview is offered by the Similarly, in North Dakota the AP (4/1, MacPherson) Huffington Post (4/1, Katz, 11.54M), another from the reports that “health insurers and enrollment counselors Huffington Post (4/1, Lavender, 11.54M), a third from the reported a surge in activity” as state residents tried to beat the Huffington Post (4/1, Schuster, 11.54M), a fourth from the midnight deadline. Huffington Post (4/1, Bach, 11.54M), and TechCrunch (4/1, In New Mexico, the AP (4/1) reports, “New Mexico is Wilhelm, 184K). expected to fall short of its goal of enrolling 40,000 to 50,000 Biden Urges The Uninsured To “Get In The Queue.” people in health insurance plans.” Sebelius wasn’t the only top Administration official who The New York Daily News (4/1, Blain, Straw, 3M) sought to tout the ACA Monday. On NBC Nightly News (3/31, reports that New York state was able to enroll “significantly” story 5, 2:25, Williams, 7.86M), Peter Alexander noted that more people than projected despite technological problems. “on daytime TV, Vice President Joe Biden tried to reassure A few outlets offer overviews of how states responded those who waited,” and “the First Lady even enlisted help to to the end of open enrollment, including the AP (4/1), CNBC make a pitch.” On ABC World News (3/31, story 2, 2:10, (4/1, Mangan, 29.84M), the Kansas Health Institute (3/31), Sawyer, 7.43M), Jon Karl also reported that Biden “visited an the Topeka (KS) Capital-Journal (3/31, Hart, 114K), he enrollment center in Washington and made a last-minute Kansas City (MO) Star (3/31, Stafford, Campbell, 1.29M), and pitch with Rachael Ray.” Biden: “Any young person listening, the Tampa Bay (FL) Times (4/1, Tillman, 43K). if you don’t need this for your peace of mind, do it for mom. Do it for your dad. Get health coverage, do it for mom.” Sebelius Discusses ACA As Open Enrollment The AP (4/1, Lederman, 11.54M) reports that at the Draws To A Close. To mark the official end of the Carlos Rosario International Public Charter School, “a few Affordable Care Act’s first open enrollment period, HHS miles from the White House,” Biden “told people waiting at Secretary Kathleen Sebelius gave a series of interviews, via the school that once they have health care, they won’t have satellite, on Monday. In one interview, with a CBS News (4/1, to stay in a job they don’t like.” 1.32M) affiliate in Oklahoma, Sebelius told the anchor that USA Today (3/31, Madhani, 5.82M) reported that Biden “somewhere between 80, 85, some say as high as 90 percent “appeared in a pre-taped video call on the Rachael Ray have paid so far” for the plans they purchased under the law. Show,” and “underscored that any Americans who are in process of signing up for health care as of midnight will be 4 eligible to sign up even if they aren’t able to complete million, and cripple the companies they have spent a lifetime enrollment by the end of the day.” Biden is quoted as saying, building, or they become complicit in a grave moral wrong.” “It’s a little bit like people when the polls close at 8 and there Attorney Ronald Goldfarb, writing in The Hill (4/1, 76K) are 100 people waiting, they get to vote. ... Get in the queue. “Pundits Blog,” complains that “the Supreme Court has taken There is still time today.” the classic notion that corporations are people to troubling The Daily Caller (3/31, Hurtubise, 135K) noted that levels.” He opposes the notion that corporations possess “while Monday is technically the final day of the open religious freedom. enrollment...the Obama administration will allow anyone who The Washington Post (4/1, Kessler, 2.33M) “Fact checks a box claiming technological problems while signing Checker” blog analyzes a recent claim by Rep. Debbie up to enroll until an unspecified date in mid-April.” Wasserman Schultz (D-FL) who, in seeking to defend the ACA’s contraception mandate, claimed that “99 percent of Poll: Support For ACA Climbs To 49%. The women used birth control in their lifetime and 60 percent use Washington Post (4/1, Clement, Craighill, 2.33M) reports that it for something other than family planning.” Ultimately, the a new Washington Post-ABC News poll found that Fact Checker rules that the claim was made without the “Democrats are rallying back behind the 2010 health-care law correct context, thus earning “Two Pinocchios,” which stands and boosting President Obama’s ratings for handling the for “Significant omissions and/or exaggerations.” law’s rollout,” while “most Republicans and independents Leonard Pitts in the Detroit Free Press (4/1, 624K) and remain stubbornly opposed to Obama’s signature first-term Reed S. Dunn in the Joplin (MO) Globe (4/1, 64K) also achievement.” The Post reports that “49 percent support and comment on the case. 48 percent oppose the health-care law in the new poll, hardly changed from January (46-49 support-oppose) but clearly Medicaid Expansion Proponents Continue better than November, when 40 percent expressed support Push. Even as the first open enrollment period of the and 57 percent were opposed.” The Post notes that Affordable Care Act ends, the debate over Medicaid “Democratic support has surged to a record-tying 76 percent, expansion rages on, with advocates pushing in several jumping 11 percentage points since January,” but 78% of states. Republicans oppose the ACA. Kaiser Health News (3/31, 2K) reports that Utah’s The Hill (3/31, Easley, 76K) “Healthwatch” blog notes proposed Medicaid expansion plan could provide an example that in the WPost-ABC poll, 54% of independents said they to other Republican-led states that have thus far been reticent “oppose” the ACA “against only 44 percent who say they to participate in the Affordable Care Act program. Gov. Gary support it.” Herbert (R) is currently pressing Federal officials to provide Bloomberg News (4/1, Bender, 392K) reports that Rep. the state with a waiver that would allow it to implement a James Clyburn (D-SC), in an appearance on Bloomberg unique form of expansion. Television, said he and his fellow Democrats “must do a In Virginia, the AP (4/1) reports that state officials spent better job of selling Obamacare” because “if we don’t do it, yesterday making “last minute phone calls and appointments we get wiped out” in November’s midterm elections. in anticipation of a midnight deadline to obtain insurance under” the Affordable Care Act. However, despite the efforts Supreme Court Turns Away Early Look At to increase enrollment, lawmakers continued “a pitched Additional Contraceptive Mandate Challenge. partisan battle” over Medicaid expansion. The AP (4/1) reports that the Supreme Court has “turned In Michigan, the Detroit Free Press (4/1, Erb, 624K) away an early look at a challenge by religiously affiliated not- reports that the Wolverine state’s expanded Medicaid for-profit groups” to the Affordable Care Act’s contraceptive program, Healthy Michigan, has extended “publicly funded mandate. Reuters (4/1, Hurley) adds that the plaintiffs, mostly health care coverage to 470,000 Michiganders.” MLive (4/1, Roman Catholic groups, were referred back to Washington’s Mack, 153K) reports on Medicaid enrollment from Federal Appeals Court for a decision. Kalamazoo. Commentary Considers Hobby Lobby’s Case In West Virginia, the AP (4/1, Plummer) reports that Against Contraception Mandate. Several sources offer enrollment in the state’s expanded Medicaid program has opinions on the Hobby Lobby case that is currently being widely exceeded initial projections. Friday’s total of 104,820 considered by the Supreme Court. Medicaid signups passed the target of 63,000, set in January. An editorial in the Tampa (FL) Tribune (4/1, 467K) In Maine, the Bangor (ME) Daily News (3/31, Thistle, argues that the Affordable Care Act “undermines religious 166K) reports on a bill that would revoke funding for a study beliefs.” The editorial quotes a prior court decision opposing into Medicaid expansion by the Alexander Group. The bill is the contraceptive mandate: “[Plaintiffs] can either abide by unlikely to pass. the sacred tenets of their faith, pay a penalty of over $14 5 Commentary Considers Medicaid Expansion. Dr. estimated half of recipients of subsidized insurance coverage Robert F. Graboyes and Dr. Mario Villarreal, both economic under the Affordable Care Act “will lose it within a year specialists with George Mason University, complain about the because of changes in their incomes or other family “cruel realities” of Medicaid in the Dallas Morning News (4/1, circumstances, such as divorce, relocation or the births of 823K), noting that expansion of the program will not help children.” The same rate applies to Medicaid recipients. The improve people’s health. process of moving between different insurance systems is Alice Murray, president of the Dallas Citizens Council, known as “churning,” and it causes disruptions in continuity of writes an opposing piece in the Dallas Morning News (4/1, care and poses the risk of leaving people uninsured for 823K), saying “expansion of Medicaid is beneficial for periods of time. business and a positive for our state’s future.” The Harrisburg (PA) Patriot-News (4/1, Micek, 264K) Commentary Considers ACA As Open “Monday Morning Coffee” blog also comments on the issue. Enrollment Period Ends. Several outlets Tuesday carry opinion pieces weighing in on various aspects of the Connecticut Offering “Exchange In A Box.” The Affordable Care Act, many of them making note of open Wall Street Journal (4/1, Boulton, 4.25M) “CIO Journal” blog enrollment’s official end. reports that Connecticut is preparing what it is calling an In a column titled “Making Up Good News About “exchange in a box” to offer options for other states looking to Obamacare” for the Washington Post (4/1, 2.33M), Marc A. capitalize on its success running its own exchange. The Thiessen seeks to downplay the positive pronouncements the program has attracted interest from Maryland, which is Obama Administration is making about the Affordable Care replacing its own foundering exchange with the technology. Act as its first open enrollment period comes to an end. For Connecticut’s exchange is regarded as one of the nation’s example, he says while the White House has “achieved its best according to several measurements. (downwardly revised) goal of signing up more than 6 million Kaiser Health News (3/31, 2K) reports on Maryland’s Americans,” no one really knows how many people have paid exchange, focusing on its plans to use Connecticut’s their premiums. technology. However, in his Los Angeles Times (4/1, 2.38M) column, Michael Hiltzik calls the figures “huge” and predicts New Hampshire Uninsured Face More Republicans will soon resort to “excuse-making” to downplay Coverage Options Under ACA. The Kaiser Family them. Foundation (4/1, 9K) reported in a 1,000-word article on how In an analysis for the New Yorker (4/1, 5.09M) “Daily the Affordable Care Act might affect the uninsured in New Comment” blog, James Surowiecki considers how important Hampshire. The law offers expanded access to health “young invincibles” are to the success of the Affordable Care insurance through several provisions. The article concluded, Act. He concludes that getting healthy people to sign up is “The ACA will help many currently uninsured people from “more important” than their just being young. New Hampshire gain health coverage by providing coverage In an editorial, the Washington Times (4/1, 230K) puts options across the income spectrum for low and moderate- its support behind the lawsuit alleging the Federal income people.” NPR (3/31, Keith, 260K) carried the piece on government cannot disperse subsidies under the Affordable several of its broadcasts Monday. Care Act, which “found a receptive audience in the three- judge appellate panel last week.” Volunteers Canvassing For ACA Arrested In Additional commentary is offered by Forbes (4/1, 6M), Chicago. The Washington Times (4/1, Chasmar, 230K) another piece in Forbes (4/1, 6M), the Kennebec (ME) reports that Chicago police charged two men for “‘soliciting Journal (4/1, 58K), and the Huffington Post (4/1, Sharpton, unlawful business’ after they were found going door to door 11.54M). trying to inform people on Obamacare.” According to a local CBS affiliate, police “responded after receiving a report that the men may have been scamming elderly residents of the MEDICARE NEWS Garfield Ridge neighborhood.” However, Felipe Hernandez Senate Approves Medicare Payment Patch and Kevin Tapia “are volunteers at the Brighton Park Neighborhood Council, and were only trying to inform Legislation. Bloomberg News (4/1, Hunter, 392K) reports residents on how to sign up for government health care.” that yesterday, the Senate approved a “one-year delay of a 24 percent cut in payment rates for physicians who accept Half Of ACA Subsidy Recipients Projected To Medicare patients.” Become Ineligible Within 12 Months. McClatchy The AP (4/1, Taylor) reports that the President “is (4/1, Pugh, Subscription Publication, 13K) reports that an expected to quickly sign” the measure. 6 The Washington Post (4/1, Lowery, 2.33M) “Post rehabilitation at Fletcher Allen Health Care in Burlington, VT, Politics” blog reports that the Senate “voted 64 to 35 to pass commented, “This takes the most disabled heart patients and the bill...after House Republicans used a rare voice-vote to gives them a chance to improve their functional capacity and get the measure through the lower chamber due to quality of life.” The Journal notes that a 2,300-patient study, uncertainty over whether the bill had sufficient support to HF-Action, helped to influence Medicare’s decision. Dr. Ades pass.” and other experts for the American Association of The Hill (4/1, Cox, 76K) “Floor Action” blog reports that Cardiovascular and Pulmonary Rehabilitation, the American “Reid said he would have preferred to pass a full repeal of the College of Cardiology, AHA and the Heart Failure Society of Medicare sustainability growth rate (SGR) pay-for rather than America, used this data, as well as other recent research, to a 13-month extension that isn’t paid for.” argue for the extended coverage for cardiac rehab. Tamara Politico (4/1, Haberkorn, 73K) reports, “Earlier on Syrek-Jensen, acting director for the coverage and analysis Monday,” Senator Ron Wyden (D-OR) “tried to pass the group at CMS, said, “When you look at the big picture, it was permanent repeal of the SGR and paid for with the Overseas a positive step forward.” Contingency Operations funds but...Sen. Jeff Sessions (R- AL) objected.” Then, “Sessions proposed an SGR repeal paid Blog: Journalists Overlooking Protecting for by repealing the health law’s individual mandate,” but Access To Medicare Act Of 2014. John O’Connor “Wyden objected.” writes in the McKnight’s Long-Term Care News (4/1, 921) The National Journal (4/1, Subscription Publication, “Daily Editors’ Notes” blog that journalists have overlooked 505K) reports, “The Senate’s vote is widely viewed among the Protecting Access to Medicare Act of 2014. He mentions the doctor community as the disappointing conclusion of a the bill’s relevance to sustained growth rate payments, long, bipartisan, bicameral effort to come to agreement on a electronic health records, and skilled nursing facility “value- long-term repeal and replacement of” the SGR. In an email, based purchasing,” adding that, “unless you’ve been reading AMA President Dr. Ardis Dee Hoven said, “Too many in McKnight’s, there’s a good chance you still wouldn’t know Congress lacked the courage and wherewithal to what’s in this bill for you.” permanently fix Medicare to improve care for patients and provide greater certainty for physician practices.” Dr. Hoven INDUSTRY NEWS added, “Congressional leadership had to resort to trickery to pass an SGR patch that was opposed by physicians.” American Heart, Stroke Associations Release Government Health IT (4/1, 12K) points out that the legislation “pushes back the compliance deadline for ICD-10.” Stroke Survivor Care Recommendations. Also covering the story is Reuters (4/1). McKnight’s Long-Term Care News (4/1, Mullaney, 921) writes the American Heart Association/American Stroke Association Senate Approves Bill To Reduce Payments To spoke Friday of the “enormous” palliative care needs stroke Doctors For Certain Medical Procedures. The survivors have. The associations recommended that all healthcare providers ensure the ability to provide these Washington Post (4/1, Whoriskey, 2.33M) reports that a services, emphasizing the importance of coordination measure approved Monday by the Senate “calls for finding between different physicians and providers, including nurses, reductions of hundreds of millions of dollars in what the therapists, providers, neurologists, and other specialists. The government spends for physician fees on overpriced medical statement appears in the journal Stroke (3/27, 73K). procedures.” The measure, which was approved by the house last week, “instructs Medicare officials to review the Expert Panel Releases Recommendations. value of some procedures and sets a target for reductions of McKnight’s Long-Term Care News (4/1, Mullaney, 921) misvalued codes of hundreds of millions of dollars.” In reports that on Friday, an expert panel released its addition, it orders the GAO “to study the AMA process for recommendations “to create a functional status quality setting the value of procedures.” measure in SNFs, as well as inpatient rehabilitation facilities Cardiac Rehab Programs Now Covered By and long-term care hospitals.” However, it had also elected not to recommend using Minimum Data Set Section G items Medicare. On the front of its Personal Journal section, the in determining a “restorative goal.” The panel included Wall Street Journal (4/1, D1, Winslow, Subscription “rehabilitation clinicians, administrators and researchers” Publication, 4.25M) reports that after a recent Medicare convened by RTI International and CMS. reimbursement rule change, rehabilitation programs are becoming available to more people suffering from chronic NYTimes Reviews Book About Caregiving. In heart failure. Philip Ades, medical director of cardiac print and in its “The New Old Age” blog, the New York Times

7 (4/1, D6, Gross, 5.41M) reviews the poetry and short story “reinvigorated focus” on improving that quality under its new book “Living in the Land of Limbo.” The book is a collection of leadership. stories and poems with a theme of caregiving from “some of the most renowned authors of the past half-century.” Developer Plans To Construct Second, Third California Senior Living Facilities. The CEO: ARIA, GROWTH Keys To Success. The Sacramento (CA) Business Journal (4/1, Van Der Meer, Eden Alternative CEO Chris Perna writes in a McKnight’s Subscription Publication, 41K) reports Oakmont Senior Living Long-Term Care News (4/1, 921) op-ed that strong expects to construct two new facilities in Carmichael and leadership and execution are key to success in the long-term Folsom, CA. The company already has a waiting list for its care industry. He emphasizes the importance of individuals Roseville, CA, senior living center. being willing to share power and using “the principle of ARIA (Authority, Resources, Information, and Accountability).” For Copyright 2014 by Bulletin News, LLC. Reproduction execution, he recommends using the “GROWTH model” (i.e., without permission prohibited. Editorial content is drawn from “Get Real,” “Reach Out,” “Open Up and Dream,” “Work Up a thousands of newspapers, national magazines, national and Plan,” “Take Action,” and “Hold Steady and Reach Further”). local television programs, and radio broadcasts. The Office Family Caregiver Trend Impacting Individuals, of the AHCA/NCAL Gazette is published five days a week by BulletinNews, which creates custom news briefings for National Workforce. Forbes (4/1, Dill, 6M) reports in a government and corporate leaders. We can be found on the 1,400-word article that family caregivers, or people “providing Web at BulletinNews.com, or called at (703) 483-6100. any kind of ongoing support and care to family members who have some level of dependency,” are expected to represent about half the American workforce within the next five years. While it is not necessarily easy to measure the impact of this growing trend, the impact it has on caregivers’ lost wages is estimated between $303,260 and $659,139 throughout retirement, with an AARP report estimating a national price tag of $33.6 billion in lost productivity. Senior Center Residents Join Program To Make Dolls For Disabled Children. The Lock Haven (PA) Express (4/1, Bauman, 26K) reports Mill Hall Senior Center residents in Mill Hall, PA, have been making Disability Dolls for children with disabilities. They are involved in the Early Head Start program, operating in conjunction with the senior center “as part of STEP, Inc., a non-profit community action agency that provides services to low income and disadvantaged individuals and families.” The organizations decided to cooperate on this project to encourage “an intergenerational connection between the children and seniors.” ASSISTED LIVING NEWS Assisted Living Concepts “Rebrands” To Reinvigorate Image. Senior Housing News (4/1, Gerace, 503) reports Assisted Living Concept LLC has changed owners and headquarters in the past year, and has recently changed its name to “Enlivant” in “a comprehensive rebranding effort.” Following corporate difficulties last year including a lease violation suit and low-quality care allegations, the name change is meant to represent a

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