THE GAZETTE ONLINE AND PRINTABLE VERSIONS AVAILABLE AT HTTP://AHCA.BULLETINNEWS.COM

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

TODAY’S EDITION Affordable Care Act/Health Reform Implementation Politico Outlines ACA Promises That Could Leave People Gallup Poll: Rate Of Uninsured Americans Has Dropped Since Feeling “Misled.” ...... 5 January...... 1 Ezekiel Emanuel Further Explains Claim That Employers Will White House Looking To Capitalize On ACA Enrollment Stop Offering Health Insurance...... 5 Figures...... 2 Commentators Debate Meaning Behind ACA’s Latest Boehner Aide Defends Against Drudge’s Assertion GOP Enrollment Figures...... 5 “Expanded” ACA...... 2 News Community Health Centers Complain About Expansion Of CMS Reverses Planned Medicare Advantage Payment Cuts. .... 6 Private Clinics Sparked By ACA...... 2 AMA Says It Will Not Try To Stop Release Of Medicare Data. .... 7 Retail Clinics Stepping Up To Meet Increased Demand For CMS Announces Hospice Quality Reporting Program...... 7 Medical Services...... 2 Investigation Finds Questionable Medicare Claims For Nerve Study: Physician Appointment Availability Greater With Private Damage...... 7 Insurance Than Medicaid...... 3 State Exchanges See Continued Problems, Growth Following Industry News Open Enrollment’s End...... 3 Senators Ask Tavenner About CMS Plans To Improve SNF ACA Medicaid Enrollment Uneven As Debates Continue...... 3 Surveys...... 7 Judge Rules MoveOn Louisiana’s Medicaid Expansion SNFs Could Be Investigated If Nurses’ Licenses Revoked...... 7 Billboards Can Stay Up...... 4 Brain Health Registry Seeks To Recruit Trial Subjects...... 7 Florida Gubernatorial Frontrunners Face Off Over ACA...... 4 Nebraska Governor Vetoes In-Home Care Funding Bill...... 7 North Carolina Hobby Lobby Picketed By Supporters Of ACA. ... 4 Stolen Flash Drive Puts People’s Information At Risk...... 7 Gives Sarcastic Answer To ACA Inquiry In Genworth Ranks Most Expensive US States For LTC...... 8 Interview...... 5 Howard Dean Discusses ACA’s Future...... 5 Assisted Living News GOP Donor Posts “Humorous Parody” Featuring Hitler Meme ALF Developer Garners Support By Not Sending Brochure To Complaining About ACA...... 5 Nearby Residents...... 8 Advocates Seek To Gauge ACA Effects Before Changing Hawaii ALF Breaks Ground...... 8 HIV/AIDS Program...... 5 Salem, Massachusetts ALF Would Be Across The Street From Website Has Become “Trusted” Source For ACA Data...... 5 Existing Senior Center...... 8

Gallup’s sentiment that the findings are “a sign that the AFFORDABLE CARE ACT/HEALTH Affordable Care Act...appears to be accomplishing its goal of increasing the percentage of Americans with health insurance REFORM IMPLEMENTATION coverage.” Some even note the connection right in their headlines: CBS News says, “As Obamacare Kicked In, Gallup Poll: Rate Of Uninsured Americans Has Coverage Went Up, Survey Shows,” and NBC News titles its Dropped Since January. Several major outlets, both report “Obamacare Lowers Uninsured Rate, Gallup Finds.” online and in print, cover a new Gallup poll which found a However, takes a different tack, headlining its marked decrease in the number of uninsured Americans story: “Gallup Survey Suggests Sign-Ups Under ObamaCare since the beginning of the year. Many of the pieces echo Not as High as White House Says.” For its part, the AP (4/8, Alonso-Zaldivar) reports that — helps give the administration more space to talk about according to the Gallup-Healthways Well-Being Index, “the other issues.” share of adults without health insurance shrank from 17.1 Or, as the Congressional Quarterly (4/8, Reichard, percent at the end of last year to 15.6 percent for the first Subscription Publication, 967) puts it, the White House is “still three months of 2014.” The AP says this survey “provides on a high over health law sign-ups.” independent validation for White House claims that the law is expanding access,” although “the improvement, while Boehner Aide Defends Against Drudge’s substantial, doesn’t appear as large as some of the numbers Assertion GOP “Expanded” ACA. The Hill (4/8, claimed by the law’s supporters.” The AP reports that the Easley, 237K) “Healthwatch” blog reports that an aide to “decline of 1.5 percentage points would translate roughly to House Speaker John Boehner (R-OH) has responded to more than 3.5 million people gaining coverage.” Drudge Report’s headline Sunday, which asked, The Los Angeles Times (4/8, Levey, 3.46M) reports that “Republicans Expand ObamaCare?” The aide “defended the Gallup figures show the uninsurance rate is at “the lowest GOP support” for the “Obamacare fix,” writing, “House level since before President Obama took office.” This, the Republicans have passed measures to repeal the full law, as article says, “provides more evidence the healthcare law is well as other measures to repeal parts of the law…to protect extending coverage to millions of the previously uninsured.” the American people from the law’s harmful consequences.” (4/8, Klimas, 455K) notes that The Washington Examiner (4/8, 335K) explains that the Gallup found “the uninsured rate changed the most for story Drudge linked to, from the AP, noted the change the African-Americans and low-income Americans.” According to GOP approved “eliminated a cap on deductibles for small Reuters (4/8, Skinner), the uninsured rate among African- group policies offered inside the law’s health care exchanges Americans fell more than three percentage points, and by as well as outside.” almost two percentage points among Hispanics. Additional coverage of the Gallup poll is offered by Community Health Centers Complain About Bloomberg BusinessWeek (4/8, Tozzi, 4.91M), the CNN (4/8, Expansion Of Private Clinics Sparked By ACA. 77.95M) “Political Ticker” blog, MSNBC (4/8, Whitaker, In a front-page article, (4/8, A1, Sun, 45.1M), Fox Business (4/8, Rogers, 333K), The Hill (4/8, 4.22M) reports that the Affordable Care Act “has set off an Shabad, 237K) “Healthwatch” blog, TIME (4/8, Sifferlin, intense competition for a growing number of privately insured 24.1M), AM New York (4/8, 700K), the New Hampshire Union patients, who tend to be the best-paying customers.” Leader (4/8, Solomon, 126K), Vox (4/8), and the Daily Caller According to the Post, “a variety of health providers [are (4/8, Hurtubise, 408K). Cable news programs covering the moving] into neighborhoods that were once the exclusive turf news Monday included Fox Business’ Lou Dobbs Tonight of community health centers, which are designed primarily for (4/7, 10:05 p.m. EDT, 49K), MSNBC’s Rachel Maddow Show low-income patients.” The Post says “for many consumers, (4/7, 9:22 p.m. EDT, 548K), and MSNBC’s Politics Nation having additional places to get medical care will provide more with Al Sharpton (4/7, 6:30 p.m. EDT, 894K). Finally, two choice and convenience,” but “community health centers outlets— Bloomberg View (4/8) and MSNBC (4/8, 45.1M) — worry that the bigger providers will siphon off the insured, carry opinion pieces lauding this news. leaving them with more uninsured patients.” The article highlights expansions by MedStar Health into new areas of White House Looking To Capitalize On ACA Washington DC. Enrollment Figures. The Hill (4/8, Sink, 237K) “Healthwatch” blog reports that the White House appears Retail Clinics Stepping Up To Meet Increased “ready to take advantage of a rare political victory on Demand For Medical Services. In an article titled healthcare,” hoping the news that 7.1 million people had “Drugstores Play Doctor: Physicals, Flu Diagnosis, And signed up for coverage under the Affordable Care Act will More,” (4/8, Reddy, Subscription allow “an economic push that has fizzed...to gain traction.” Publication, 5.51M) examines retail medical clinics, which are According to Administration officials, healthcare will no longer expanding to respond to the increase in demand for basic be the “biggest political story,” leaving room for the White health services brought in part by the Affordable Care Act. House to advance its efforts to “hik[e] the minimum wage to Right now in the US, retailers like CVS and Walgreens offer $10.10 per hour and extend federal unemployment benefits.” about 1,600 walk-in medical clinics. But, according to a report Similarly, Roll Call (4/8, Dennis, 76K) says from Accenture, that number will likely double over the next “unexpectedly achieving more than 7 million initial signups three years. last week — and adding another 200,000 over the weekend

2 Study: Physician Appointment Availability found numerous red flags.” The St. Paul (MN) Pioneer Press Greater With Private Insurance Than Medicaid. (4/8, Snowbeck, 656K) reports on growing political pressure Reuters (4/8, Seaman) reports on a new study, published in to find out what has gone wrong with the exchange since its the current edition of JAMA Internal , which shows launch. the availability of physicians varies depending on a patient’s In California, KTVU-TV San Francisco (4/8, 128K) insurance coverage. Researchers, from the Perelman School reports on criticism that the state’s exchange failed to target of Medicine at the University of Pennsylvania in Philadelphia, Latinos. Eleven percent of enrollees picked Spanish as their found they were able to book appointments 85% of the time first language, and Latino enrollees only account for 26.3 when claiming private insurance, compared to just 58% when percent of total enrollment. Modern Healthcare (4/8, Landen, they claimed to be covered by Medicaid. The article says this Subscription Publication, 224K) reports on the exchange’s may be good news for the millions of people who have late push to increase Latino enrollment. recently signed up for private coverage under the Affordable An editorial in the Hartford Business Journal (4/7, 10K) Care Act. offers a mixed review of Connecticut’s exchange, noting “leaders deserve praise, but plenty of work remains.” State Exchanges See Continued Problems, Exchanges Evaluate Enrollment Numbers. The New Growth Following Open Enrollment’s End. York Daily News (4/8, Blain, 4.36M) reports in its “Daily Politics” blog that “New York’s Obamacare enrollment State-run health insurance exchanges, set up under the continued to grow even after the close of the sign up period,” Affordable Care Act, are working to address problems that reaching 908,572. The Syracuse (NY) Post-Standard (4/8, have plagued several of them since their October launch. At Mulder, 859K) breaks down the numbers, noting “421,883 the same time, other exchanges are seeing growing residents have enrolled in private plans and 486,689 have enrollment due to extended time for people who suffered from signed up for Medicaid.” Also reporting on New York’s technical glitches. enrollment are Buffalo (NY) Business First (4/7, Drury, In Oregon, the Salem (OR) Statesman Journal (4/7, Subscription Publication), the Elmira (NY) Star-Gazette (4/7, Yoo, 104K) reports the story of Carol and Steven Tishmack, Hupfl, 55K), and the Lower Hudson Valley (NY) Journal News whose insurance application for insurance was placed “in (4/7, Spector, 339K). heart-wrenching health insurance limbo due to Cover In California, the North Bay (CA) Business Journal (4/8, Oregon’s inability to process applications in a timely manner.” Verel, 13K) reports on the “late surge in enrollments” that Steven’s cancer diagnosis cost the couple an estimated have brought Covered California’s enrollment past the 1.2 $150,000 in medical bills. On April 1, the couple’s insurance million mark. finally went into effect, but Steven died on the 3rd. According The Fergus Falls Journal (4/7, Rule, 12K) reports that a to the family’s insurance agent, “Carol may have to file for total of 175,000 have enrolled in Minnesota’s exchange, bankruptcy and also update her account through Cover which exceeds the original target of 135,000. Oregon, yet again throwing her insurance coverage into uncertainty.” Because of problems like the Tishmack’s, Cover ACA Medicaid Enrollment Uneven As Debates Oregon is considering replacing its “problem-plagued Coverage of Medicaid expansion today website,” according to Oregon Public Broadcasting (4/8, Continue. Foden-Vencil, 4K). A decision is expected this week. The highlights both states that have expanded the eligibility of Portland (OR) Business Journal (4/8, Hayes, Subscription their programs as well as states where political battles are still Publication, 26K) “Health Care Inc” blog offers more detail on raging. the choice between different options for the exchange. The Washington Times (4/8, Howell, 455K), an analysis Another post in the Portland (OR) Business Journal (4/8, from Avalere Health, “a Washington consultancy,” ten states Hayes, Subscription Publication, 26K) “Health Care Inc” blog “accounted for more than 80 percent of the 3 million new also discusses the exchange. Medicaid enrollees who have signed up through Obamacare In Minnesota, the Minneapolis-St. Paul (MN) Business this year,” and Florida “was the only state to enroll more than Journal (4/8, Reilly, Subscription Publication, 56K) reports 100,000 residents without expanding the federal-state that April Todd-Malmlov, MNsure’s former director, made her entitlement under the new law.” The Times notes that CBO most extensive comments to date about her time at the “estimated that 8 million new Medicaid enrollees would join exchange, specifically addressing its “troubled launch.” She the program in 2014,” and CMS has reported that “through acknowledges her role, but largely points to outside February, 3 million new enrollees had joined Medicaid.” The problems: “She says that she told MNsure directors that Congressional Quarterly (4/8, Adams, Subscription glitches were possible, but didn’t share with them that Publication, 967) also reports on the news, noting “if the rate consultants evaluating the health exchange website had of enrollment remains at the same pace in March as in 3 February, then about 700,000 people would be expected to Tag Is Rising By The Month Under Obamacare’s Medicaid enroll in March.” Expansion.” The AP (4/8) reports that Michigan has seen more than An editorial in the Newport News (VA) Daily Press (4/8, 46,000 applications since last week’s launch of its expanded 206K) calls on Virginia lawmakers to “Find a way forward” on Medicaid program. the issue of Medicaid expansion in order to prevent a state In Virginia, the Washington Post (4/8, Vozzella, 4.22M) government shutdown. reports that the Virginia Hospital and Healthcare Association In a US News & World Report (4/7, 645K) opinion has hired former Virginia Transportation Secretary Sean piece, Darcy N. Bryan warns against expansion, warning, Connaughton, a move that “surprised and upset some people “State and federal governments consumed with paying for on both sides of the Medicaid debate.” The hiring of a medical bills may not be able to provide all of the services Republican known for his willingness to engage in tough that people in poverty rely on—and which may one day allow political battles is seen as a signal that the group “is preparing them to escape poverty altogether.” for a bare-knuckle fight with Republicans over whether to expand Medicaid under the federal health-care law known as Judge Rules MoveOn Louisiana’s Medicaid Obamacare.” The Roanoke (VA) Times (4/8, Sluss, 264K) Expansion Billboards Can Stay Up. The Baton reports that the state Senate will vote on a Medicaid Rouge (LA) Advocate (4/8, Gyan, 22K) reports that US expansion bill today. The issue has caused legislative District Judge Shelly Dick ruled that liberal political group gridlock that has held up the state budget. If an agreement is MoveOn.org is allowed to continue using the Louisiana’s not reached, the government of Virginia will partially shut trademarked tourism slogan “Pick Your Passion” in its down. Also reporting on Medicaid expansion in Virginia are advertising campaign supporting Medicaid expansion. the Hampton Roads (VA) Virginian-Pilot (4/8, Walker, 422K), The Huffington Post (4/8, Alman, 11.54M) also reports the Lynchburg (VA) News & Advance (4/8, Rohr, 77K), the on the ruling. Richmond (VA) Times-Dispatch (4/8, Martz, 333K), the Newport News (VA) Daily Press (4/7, 206K), and another Florida Gubernatorial Frontrunners Face Off article in the Newport News (VA) Daily Press (4/7, 206K). Over ACA. The Orlando (FL) Sentinel (4/7, Powers, 850K) In Ohio, the Cleveland Plain Dealer (4/8, Ridel, 1.06M) “Political Pulse” blog reports on the role the Affordable Care reports that Medicaid expansion is playing an important role Act is playing in Florida’s gubernatorial race, noting cheekily: in state politics. Democratic “frontrunner” Charlie Crist “is standing by his In Missouri, the Howell County (MO) News (4/8) reports support” of the law, and Republican Gov. Rick Scott’s “re- that Gov. Jay Nixon is continuing to advocate for Medicaid election campaign is standing by Crist’s support” of it, too. expansion, highlighting a new study that projects expansion Illustrating this, the blog says Scott’s “independent re-election could create billions of dollars of economic activity and campaign committee, Let’s Get To Work,” recently launched thousands of jobs in the state. “a second TV commercial attacking Crist for supporting the In Pennsylvania, the AP (4/8, Levy) and the Harrisburg health care law,” based on President ’s (PA) Patriot-News (4/8, Wenner, 397K) report on forceful “infamous statements that people who like their health care advocacy for Medicaid expansion. plans can keep their health care plans.” The Glenwood Springs (CO) Post Independent (4/8, The Naples (FL) Daily News (4/8, Staats, 167K) reports Grandbois, 27K) reports on the local effects of Medicaid that Crist “doubled down Monday on his support for expansion in Colorado. Obamacare days before Gov. Rick Scott’s campaign rolls out Commentary Discusses Medicaid Expansion. An new TV ads attacking Crist on it.” He said, “We’re not backing editorial in the Boston Globe (4/8, 1.62M) calls on Maine Gov. away, we’re not backing down and we’re coming.” Paul LePage (R), “a Tea Party-linked Republican,” to stop New Anti-ACA Ads Target Colorado, Iowa vetoing Medicaid expansion bills that are sent to him by his Democrats. The Daily Caller (4/8, Levinson, 408K) reports legislature. on a new ad campaign, “targeting Democrats in the Iowa and Mark Dakkak, in a Raleigh (NC) News & Observer (4/7, Colorado Senate races” for their support of the Affordable 504K) op-ed, considers the state of healthcare in North Care Act. The ads are sponsored by Freedom Partners, “a Carolina under the Affordable Care Act. The state had the conservative group with ties to the Koch brothers.” third-most enrollments of any state using healthcare.gov, but the state’s decision not to participate in Medicaid expansion North Carolina Hobby Lobby Picketed By has left thousands of low-income residents without coverage. Supporters Of ACA. The Wilmington (NC) Star News The Forbes (4/8, Archambault, 6.28M) “Apothecary” (4/8, Wagner, 123K) reports that “a group of about 20 people” blog runs an op-ed entitled “Arkansas’ ‘Private Option’ Price gathered around the Wilmington Hobby Lobby on Monday to

4 protest the craft chain’s lawsuit designed to gain exemption Website Has Become “Trusted” Source For from the Affordable Care Act’s contraception mandate. One ACA Data. Sarah Kliff, in a 1,600-word piece for Vox (4/8), poster board read: “Hobby Lobby: Focus on crafts not profiles Charles Gaba, “the Obamacare enrollment guru.” crotches.” Despite having “no background in health policy whatsoever,” Rahm Emanuel Gives Sarcastic Answer To the Michigan resident’s website, ACASignsup.net, has become “the country’s most trusted source of Affordable Care The Hill (4/8, Easley, 237K) ACA Inquiry In Interview. Act enrollment data.” As Kliff explains, Gaba’s “enrollment “Healthwatch” blog reports that Mayor, and former counts are routinely more up-to-date than the federal White House Chief of Staff, Rahm Emanuel “lashed out at an government’s, which is why they turn up on newspaper front interviewer over an ObamaCare question he didn’t like.” In an pages and cable news shows.” interview published Monday, The New Republic’s Isaac Chotiner asked Emanuel “if he wished he’d been in Politico Outlines ACA Promises That Could Washington to help fix HealthCare.gov, when the website Leave People Feeling “Misled.” Politico (4/8, crashed at launch.” He responded, “That goes down as one Villacorta, 73K) outlines the Affordable Care Act’s “next of the more intriguing questions I have ever had. Did I wish I obstacle,” warning that discussion surrounding the law could was in Washington to fix a website? Let me answer that. I “combust” if people feel they were “misled” by certain have a single-word answer: No. Please do not edit out the “promises.” Among the “danger points” are the notion that all sarcasm of that answer … I don’t want it to be missed on your pre-existing conditions are covered and the “myth” that the readers.” penalty for not being covered at tax time maxes out at $95. Howard Dean Discusses ACA’s Future. The Ezekiel Emanuel Further Explains Claim That Burlington (VT) Free Press (4/8, Johnson, 116K) reports that former Vermont Governor and DNC Chairman Howard Dean Employers Will Stop Offering Health Insurance. on Monday “delivered a prognosis for Obamacare.” Robb Mandelbaum, in a piece for (4/8, Attempting to answer the question, “Does Obamacare Have a 9.65M) “You’re The Boss” blog, allows Dr. Ezekiel J. Emanuel Future?” at the University of Vermont’s Bilings Library, Dean to “further explain” his “provocative prediction that most argued, “Yes, in the short term. No, in the long term.” The employers will abandon health coverage by 2025.” That WVNY-TV Burlington (VT) Burlington, VT (4/8, Austin) claim, Mandelbaum says, “struck a nerve” with his readers. website also reports. Commentators Debate Meaning Behind ACA’s GOP Donor Posts “Humorous Parody” Latest Enrollment Figures. Several commentators Featuring Hitler Meme Complaining About Tuesday consider the Affordable Care Act in light of last week’s announcement that the law had surpassed 7.1 million Politico (4/7, Glueck, 73K) reports that “Republican ACA. enrollments. Despite the seemingly positive news, many of mega-donor” Foster Friess posted a “parody video targeting the pieces seek to dismantle the notion that the law has Obamacare…starring Adolf Hitler” titled, “Humorous parody turned a corner. of Hitler realizing he can’t keep his doctor under Obamacare.” Michael Gerson, in his column for the Washington Post Advocates Seek To Gauge ACA Effects Before (4/8, 4.22M), writes that while “supporters of Obamacare are celebrating that the law is not an unmitigated disaster,” the Changing HIV/AIDS Program. Congressional law has a long way to go. He says the “cheer” surrounding Quarterly (4/7, Attias, Subscription Publication, 967) reported the news that 7.1 million people had signed up for coverage that HR 4260, introduced last month by a group of bipartisan on the ACA’s exchanges is the latest example of “a cycle of legislators, would “make changes to the Ryan White overpromising and disappointment.” HIV/AIDS Program.” For example, the measure “would In an op-ed for the Daily Caller (4/8, 408K), Corie require the Health and Human Services secretary to submit a Whalen, a spokesperson for Generation Opportunity, calls the report to Congress by Sept. 30 on the funding allocations and news that the Affordable Care Act has hit 7.1 million sign-ups include a plan to keep each state’s funds per HIV/AIDS “this year’s worst April Fools joke.” She writes, “it might have patient from varying by more than five percent from any other been funny, if Obamacare wasn’t premised on falsehoods state.” However, “advocates want some time to gauge the that are causing problems for the economy, middle class effects of the health care overhaul” before making changes, families, and Millennials.” saying they will let the program continue to operate as it is in Judd Gregg, a former governor and three-term senator the meantime through the current process of appropriations. from New Hampshire, discusses several of the Affordable Care Act’s “failures” in an op-ed for The Hill (4/8, 237K). He 5 calls the Administration’s “touting” of the 7.1 million large-circulation and beltway media outlets. The move is seen enrollment figure as “a breathtakingly deceptive declaration,” as a victory both for lawmakers and insurers, who generally saying it “is now rather obvious that ObamaCare is not going opposed the cuts. to insure a very large share of the previously-uninsured The Wall Street Journal (4/8, Mathews, Peterson, population.” Subscription Publication, 5.51M) reports that officials with the Chris Weigant, a political writer, offers a more upbeat Centers for Medicare and Medicaid Services announced account of the 7.1 million figure in a piece for the Huffington yesterday that they were shelving controversial cuts to Post (4/8, 11.54M) blog, but cautions that “the final numbers Medicare Advantage and replacing them with payment won’t really be in for years.” increases. An estimated 16 million people are currently Additional commentary is offered by the Huffington Post enrolled in Medicare Advantage plans. CMS made the (4/8, 11.54M), Bloomberg View (4/8), another from announcement in a press release entitled “CMS Ensures Bloomberg View (4/7), Forbes (4/8, 6.28M), the Washington Higher Value and Quality for Medicare Health and Drug Plans Examiner (4/8, 335K), FOX News (4/8, 74.23M), the (4/8, 123K).” Reuters (4/8, Humer) reports that MA payments Columbus (MS) Commercial Dispatch (4/8, 41K), the to health insurers will now rise by 0.4% next year instead of Concord (NH) Monitor (4/8, 38K), the Louisville (KY) Courier- being cut by 1.9%. Journal (4/8, 468K), and the Orange County (CA) Register The Hill (4/8, Easley, 237K) reports the cuts, which (4/8, 642K). “would have reduced benefits that seniors receive from health GOP’s Anti-ACA Strategy Debated. Several opinion plans in the program,” were to be part of the Affordable Care pieces Tuesday consider continuing Republican opposition to Act’s “$200 billion in cuts to Medicare Advantage over 10 the Affordable Care Act in light of the recent gains, in years.” The announcement from CMS “comes after insurers enrollment and public perception, it has made. In an editorial, spent millions on a public relations blitz seeking to head off the Wall Street Journal (4/8, Subscription Publication, 5.51M) the cuts, and after dozens of Democrats joined Republicans defends Republicans in the House for fixing an aspect of the in calling on the administration to...avoid cutting benefits for Affordable Care Act last week, a move which has caused seniors.” some on the far right to cry foul. The paper argues that by The AP (4/8, Murphy) puts the news in the context of “a repealing the $2,000 cap on deductibles for small-businesses busy election season during which cuts to the program purchasing insurance, the GOP should be praised, not promise to be a key focus for politicians and voters.” Similarly, criticized. While maintaining their preference for repealing the The Hill (4/8, Easley, 237K) reports in its “Healthwatch” blog entire ACA, the Journal says small tweaks to make it less on the “surprising” announcement, which “came as a relief to devastating to the economy should not be avoided while the many Democrats, who feared the cuts would create a law remains firmly in place. backlash among seniors in the midterm elections.” Ramesh Ponnuru, a Bloomberg View columnist, a The Atlanta Journal-Constitution (4/7, Dupree, 1.36M) visiting fellow at the American Enterprise Institute, and a reports that the reversal has not entirely quelled Republican senior editor at National Review, warns Republicans that protests, with some members of the GOP echoing the “Obamacare isn’t dying” in an op-ed for the Allentown (PA) concerns of Rep. Pete Sessions (TX), who said “Today’s Morning Call (4/7, 339K). Because of this, he suggests that announcement from CMS doesn’t change the fact that the party “come up with proposals to replace it when they ObamaCare still cuts the Medicare Advantage program that have the power.” our seniors rely on.” House Speaker John Boehner called on Similarly, In a piece for the Huffington Post (4/8, a longer term fix to the cuts, saying “We have called on the 11.54M) blog, Kevin Price, publisher and Editor in Chief of the president and his Cabinet to develop a plan to help American US Daily Review, suggests several ways the GOP can seniors deal with the consequences, both now and in the capitalize on “Obamacare disdain” in the midterm elections future, of this destructive law. Thus far we’ve seen no such this November. plan.” Additional opinion pieces considering Republican The Washington Post (4/8, Millman, 4.22M) “Wonkblog” strategy going forward are is offered by the CNN (4/8, offers a broad overview of the fight over MA funding and the 77.95M) website and Bloomberg View (4/8). program itself. Among the many other sources reporting on the news MEDICARE NEWS are the Washington Times (4/8, Howell, Dinan, 455K), McClatchy (4/8, Pugh, Subscription Publication, 23K), the CMS Reverses Planned Medicare Advantage Congressional Quarterly (4/8, Ethridge, Subscription Publication, 967), the National Journal (4/8, Baker, Ritger, Payment Cuts. News that CMS has reversed planned Subscription Publication, 561K), the Washington Examiner cuts to a popular program attracts attention from several (4/8, Mali, 335K), Modern Healthcare (4/7, Hollander, 6 Subscription Publication, 224K), Bloomberg News (4/8, information on how CMS expects to “improve” resources and Wayne, Chen, 2.76M), Minneapolis Star Tribune (4/8, surveys. Spencer, 1.48M), the Pittsburgh Post-Gazette (4/8, Twedt, 677K), and Kaiser Health News (4/7, Hancock, 2K). SNFs Could Be Investigated If Nurses’ Licenses Revoked. McKnight’s Long-Term Care News AMA Says It Will Not Try To Stop Release Of (4/8, Mullaney, 921) reports skilled facilities could Medicare Data. The AP (4/8, Alonso-Zaldivar) reports face Federal fraud investigations if registered nurses default that the American Medical Association indicated that it will not on student loans or fail to pay their taxes. While facilities have attempt “to block Medicare’s release of billing records for access to whether such a nurse has any outstanding state 880,000 physicians, although it continues to oppose the license issues, only the RN receives notification when there is government’s recent decision to open up the massive data a problem, and they may fail to inform the SNF. According to trove.” An AMA official “told The Associated Press that the healthcare consultant and strategist Kendall Brune, nurses group won’t go to court ahead of Wednesday’s scheduled need to understand the importance of doing so, and facilities release.” According to AMA president Ardis Dee Hoven, a must “respond appropriately.” “broad approach to releasing physician payment data will mislead the public into making inappropriate and potentially Brain Health Registry Seeks To Recruit Trial harmful treatment decisions and will result in unwarranted Subjects. The San Francisco Chronicle (4/8, Colliver, bias against physicians that can destroy careers.” The article 3.33M) reports that officials with the University of California- points out that last week, in a letter to the AMA, Medicare San Francisco “hope to solve one of the biggest hurdles to deputy administrator Jonathan Blum wrote, “Over the past 30 clinical research for Alzheimer’s, Parkinson’s and other brain years, the landscape has changed with respect to physician diseases: finding people willing to be subjects in trials in a information that is available to the public.” relatively short time.” Through the establishment of “the Brain Health Registry, an online project to be announced Tuesday, CMS Announces Hospice Quality Reporting researchers hope to recruit as many as 100,000 people over Program. Modern Healthcare (4/7, Subscription the next three years to serve as a ready-made pool of Publication, 224K) reports that CMS “is establishing a new participants for studies in a wide range of neurological electronic record system for quality reporting by hospices.” diseases as well as depression, post-traumatic stress The announcement, made in the Federal Register (PDF) disorder and other brain-related ailments.” Dr. Michael says hospices will have to use the system for all patients, not “Weiner, principal investigator of the Alzheimer’s Disease just Medicare patients, starting July 1. Neuroimaging Initiative, a $140 million project funded by the National Institutes of Health that is considered the world’s Investigation Finds Questionable Medicare largest observational study for the disease,” explained that Claims For Nerve Damage. Congressional Quarterly the registry would allow money saved in recruiting patients to (4/8, Adams, Subscription Publication, 967) reports on the be applied to research. results of an audit that found “almost 29 percent of the money that Medicare spent on tests to assess nerve damage in 2011 Nebraska Governor Vetoes In-Home Care was on questionable claims.” The review was conducted by Funding Bill. The AP (4/8) reports that Nebraska Gov. the Department of Health and Human Services Office of Dave Heineman, a Republican, vetoed a bill requiring the Inspector General. state to apply for Federal in-home care service funding for elderly residents. While Heineman appreciated the bill’s INDUSTRY NEWS intent, he believed such a measure would make the state responsible for millions of dollars in expenses. Senators Ask Tavenner About CMS Plans To Stolen Flash Drive Puts People’s Information Improve SNF Surveys. McKnight’s Long-Term Care At Risk. McKnight’s Long-Term Care News (4/8, Mullaney, News (4/8, Mullaney, 921) reports that Sens. Bill Nelson (D- 921) reports the Michigan Department of Community Health FL) and Charles Grassley (R-IA) wrote to CMS Administrator has announced that thousands of people receiving long-care Marilyn Tavenner that the skilled nursing facility survey assistance “have had their personal information compromised process needs improvement. While it currently fails “to ensure due to a laptop and flash drive theft.” A state Long-Term Care resident safety,” the Senators also believe such a survey Ombudsman’s Office employee’s flash drive was stolen on process “should be able to identify problems that exist before Jan. 30 or 31 and contained more than 2,500 people’s they compromise patient care,” and they requested

7 personal information, including some 1,500 records with a Copyright 2014 by Bulletin News, LLC. Reproduction Social Security or Medicaid identification number. without permission prohibited. Editorial content is drawn from thousands of newspapers, national magazines, national and Genworth Ranks Most Expensive US States local television programs, and radio broadcasts. The Office For LTC. Senior Housing News (4/8, Gerace, 503) reports of the AHCA/NCAL Gazette is published five days a week by that according to the Genworth 2014 Cost of Care Survey, BulletinNews, which creates custom news briefings for East Coast states have significantly higher median costs than government and corporate leaders. We can be found on the other states for long-term care. Washington, DC, is the Web at BulletinNews.com, or called at (703) 483-6100. highest at $82,674, followed by Alaska and Delaware for a tie at second. Blog: Assisted Living Costs Increasing. John O’Connor writes in the McKnight’s Long-Term Care News (4/8, 921) “Daily Editors’ Notes” blog that the financial challenges of caring for an elderly person are increasing in the US, citing the Genworth survey. The annual private nursing home cost rose to $87,600 while the monthly median rate rose to $3,500. He expects increasing costs to force more Americans to rely on government handouts. ASSISTED LIVING NEWS ALF Developer Garners Support By Not Sending Brochure To Nearby Residents. Newsday (4/8, Morris, 1.5M) reports Benchmark Senior Living mailed a brochure to Huntington, NY, residents to elicit support for a proposed assisted living facility, but failed to send the brochure to residents living nearby who opposed the project. Many residents who failed to receive the brochure are angry and have demonstrated environmental concerns, as well as concerns about how the facility would change the area’s character. Hawaii ALF Breaks Ground. Pacific Business News (4/8, Blakely, Subscription Publication, 53K) reports that yesterday Hawaii’s Plaza Assisted Living broke ground on its Plaza at Waikiki project. Construction will likely continue into the end of 2015. Salem, Massachusetts ALF Would Be Across The Street From Existing Senior Center. The North Andover (MA) Eagle Tribune (4/8, Ireland, 101K) reports that a Salem, MA assisted-living facility and Alzheimer’s care unit have been proposed. If approved, they will be built across the street from the existing Ingram Senior Center.

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