October 21, 2009
With the rejection in the Senate Finance Committee of two separate proposals to create a substantial public health insurance option and, instead, the approval of the relatively weak co-op proposal (which the CBO estimates to be unlikely to establish a meaningful presence and will result in only half the budget amount of $6 billion will be spent) it seemed as though the public option had breathed its last breath. However, new developments indicate that the public option, in various forms, is still alive.
Senator Schumer (D-NY), having failed to pass his “level playing field” public health insurance option proposal in the Finance Committee, is pushing a new public health insurance option that would allow states to “opt out” of the public plan. The opt-out proposal is gaining fans in the Democratic Caucus, even amongst conservative Democrats who are worried the effects a public plan could have on their state.
September 30, 2009
I just found an interesting article on theglasshammer.com called “Goldman Sachs Returnship (SM) Program Helps Top Women On-Ramp Into Finance.” In it, we learn about Goldman Sachs’ “returnship” program, which lasts eight weeks and begins on October 19, 2009. The program will offer training and guidance to help highly skilled women return to the financial workforce after having taken voluntary breaks that may have lasted anywhere from a few years to a couple of decades. While participants are not guaranteed jobs at Goldman Sachs at the end of the program, Goldman Sachs has hired more than half of the participants from last year’s returnship program.
What are “returnships”? They are similar to internships, except that returnships are targeted toward experienced workers who want to return to the workforce full time. The returnship program may or may not pay the participants, and it may last weeks or months.
August 26, 2009
Perhaps in recognition of its benefits to areas affected by shortfalls in specialists and primary care physicians or the need for remote monitoring, telemedicine received significant funding in the ARRA. For instance, the Rural Utilities Service was allocated $2.5 billion to fund “shovel-ready” distance learning, telemedicine, and broadband program; the Indian Health Services received $85 million to fund telemedicine; and a portion of the $2 billion allocated to the Office of the National Coordinator is to be used to support the “infrastructure and tools for the promotion of telemedicine.” However, in contrast to the ARRA, the current reform proposals publicly available are missing language facilitating telemedicine which otherwise could be a key component to one of the goals of health reform, bending the cost curve.
The only attention telemedicine receives in the House Tri-Committee Bill – the America’s Affordable Health Choices Act of 2009 – is in the creation of the Telehealth Advisory Committee. This Committee will advise and make recommendations to the HHS Secretary regarding policies for payment of telemedicine services. However, the Senate HELP’s Bill – the Affordable Choices Act – does not even mention telemedicine.
August 3, 2009
On July 27, 2009, the U.S. Court of Appeals for the Ninth Circuit held that a corporation’s managers can be held personally liable under the Fair Labor Standards Act (“FLSA”) for wages that the corporation failed to pay to employees prior to the employer’s filing for bankruptcy. This opinion serves as a cautionary reminder of the risks managers potentially face when a corporation files for bankruptcy and has failed to pay its employees for all wages earned prior to the filing.
In Boucher v. Shaw, —- F. 3d —-, 2009 WL 2217517 (9th Cir. 2009), former employees of the Castaways Hotel, Casino and Bowling Center sued three senior managers for unpaid wages under Nevada state law as well as federal law. The managers moved to dismiss the claims based on, among other grounds, the fact that the hotel had filed for bankruptcy protection. The Ninth Circuit asked the Nevada Supreme Court to address the issue of whether, under state law, the managers could be personally liable as “employers” for the unpaid wages. The Nevada Supreme Court ruled that individual managers are not “employers” under state law. However, the Ninth Circuit ruled against the managers on the federal FLSA claims and allowed the employees’ claims to proceed.
July 28, 2009
Recently, the Ark Group’s WOMENLEGAL 2009 forum brought together gender-diversity thought-leaders in New York for an important conference on women in the legal profession. The forum focused on the key career issues facing women lawyers today, and practical solutions for both women lawyers and law firms regarding retaining and advancing women in the legal profession.
Carol Frohlinger’s excellent article, “What Women Want,” thoroughly covers the forum in the June-August issue of WOMENLEGAL Magazine.
July 11, 2009
As the “Three Tenors” (Chairmen Waxman, Miller and Rangel) struggle to finance the access enhancements that are central to the President’s health reform aspirations, the need for meaningful payment reform continues to challenge. This week House Speaker Nancy Pelosi urged the Chairmen to sharpen their pencils in this regard. Moreover, in a letter to the Speaker and Majority Leader Steny Hoyer, the fiscally-conservative “Blue Dog” coalition of House Democrats has now said that the current drafts fail to include sufficient structural reforms likely to succeed in lowering costs and incenting “value” (in purchasing).
July 8, 2009
I recently read an enlightening study by Development Dimensions International (DDI) — “Holding Women Back: Troubling Discoveries and Best Practices for Helping Female Leaders Succeed” — which reveals that, worldwide, women are simply not getting the same career opportunities as men. The study is based on responses from 12,800 leaders in 76 countries and approximately 1,500 organizations. However, the study also offers advice on how to overcome such challenges.
We learn that, in addition to earning lower salaries than men, women are often overlooked when employers single out “high potentials” — employees who have strong leadership potential. High-potential employees are placed in accelerated development programs to foster their leadership skills. The DDI study reveals that the gap between men and women in high-potential programs widens as management levels increase: “there were 28 percent more men than women in high-potential programs at the first level of management and 50 percent more men than women in such programs at the executive level.” As a result, fewer women than men reach senior leadership positions.
June 13, 2009
For the last week or so, the health reform public policy debate has been keyed to the Senate HELP Committee’s draft and thus dominated by whether or not the “Exchange” to be employed in access reform should include a “public plan” and, if so, whether such a plan should have the power to access provider payment rates tied to Medicare and whether Medicare participating providers would be required to contract with it. With this week’s release of the Senate Finance Committee’s draft, it will be interesting to see whether payment reform can similarly capture the attention of the press. Frankly, we have low expectations in this regard insofar as the consequences that the prevalence of fee for service payment methodologies have on health care output are hard to grasp relative to the easier concept of “universal coverage”. Perhaps it is ultimately less important that payment reform capture the air waves than the degree to which payment reform is incorporated in whatever pieces of health reform make it through this session of Congress.
May 29, 2009
Although there are some big issues that remain unresolved, such as the “public plan” component, it appears that we will see reform legislation pass in 2009. Drafts of the legislation are being prepared now by various members of Congress and their staffs.
The focus on medical homes, physician hospital organizations and accountable care organizations is very real, as is the focus on payment reform, including bundled payments and other forms of capitation-like reimbursement. A key element of the debate relates to “how integrated” a provider organization will need to be to qualify for bundled payments. Can it be virtual? Can it be physician only or must a hospital be involved? What should be the role of private payors?