(INDIANAPOLIS, Ind.) –Lt. Gov. Kim Reynolds today was named chair of the National Lieutenant Governors Association (NGLA) at the group's annual meeting in Indianapolis, Ind.  Reynolds, a second-term lt. governor, has previously served as chair-elect, treasurer, and chair of International Relations Committee and the Policy Resolutions Committee of the NLGA - all positions which she was elected unanimously by her peers. A photo of Reynolds can be found here.

"I am honored to have been selected by my fellow lieutenant governors to chair this prestigious organization and pledge to collaborate with my colleagues to continue aligning states' workforces with business' demands to grow the economy, while providing our children with a world-class education that prepares them for the careers of tomorrow," said Reynolds.  "By bringing together a diverse group of leaders, the NLGA will continue to be a valuable resource for sharing innovative state-based solutions for the challenges shared across the country.

In her role as head of the NLGA, Reynolds will chair an October meeting in Connecticut, a March 2016 meeting in Washington D.C., and a July 2016 in Michigan.  She will serve as leader of the organization until the conclusion of the July 2016 Michigan meeting.

NLGA is a professional association enabling policy discussion on a broad range of topics, an exchange of best practices, and an opportunity for lieutenant governors to develop leadership priorities for their states.

WASHINGTON, D.C. - Congressman Dave Loebsack (D-IA) joined with Congresswoman Lynn Jenkins (R-KS) to introduce H.R. 2878 to prevent Medicare's enforcement of unreasonable and inflexible direct supervision rules for outpatient therapy services at Critical Access Hospitals (CAHs) and other small, rural hospitals. This legislation was introduced by Loebsack and Jenkins in the 113th Congress and passed the House by a voice vote on September 9, 2014. The bill was signed by the President on December 4, 2014 and became public law. However, the law has expired and was introduced again by Congressman Loebsack and Congresswoman Jenkins.

"I am pleased to again join with Rep. Jenkins and work in a bipartisan manner to ensure all Iowans have access to high-quality health care no matter where they live," said Congressman Loebsack. "Critical Access Hospitals play an important role in rural communities by providing access to primary, emergency, and acute care services. I have visited multiple CAHs across my District that have struggled to meet the direct supervision requirement, and this important legislation will provide them with certainty that they deserve."

"Rural communities in Kansas and across the country depend on Critical Access Hospitals," said Congresswoman Jenkins. "CAHs are the lifeblood of their communities, and this legislation corrects a decision from the Centers for Medicare and Medicaid Services that puts a strain on providers without providing any quality improvements for the patients they serve. I was proud to lead a bipartisan push with Senator Moran last Congress to make this bill law, extend the direct supervision requirement moratorium, and give much-needed certainty to rural hospitals. I hope that Members from both parties can once again come together to ensure that high-quality, timely care is available no matter where you live in America."

Items to Note:

·       There are 1,332 CAHs across the country, 82 in Iowa.

·       Companion legislation was introduced in the Senate by U.S. Senator's John Thune (R-S.D.), Jerry Moran (R-Kan.), and Jon Tester (D-Mont.). S. 1261 passed out of the Senate Finance Committee on June 24, 2015.

Examples of direct supervision rules for outpatient therapy services: 

·       Application of cast to a finger

·       Blood transfusions

·       Application of a splint to a finger

·       Demonstration and/or evaluation of a patient utilizing a nebulizer or metered dose inhaler

·       Alcohol and/or substance abuse (other than tobacco) structured assessment and brief intervention (such as advising of health risks and counseling for 15-30 mins)

·       Pulmonary rehabilitation, including exercise of one hour per session - up to two sessions per day

What They Are Saying:

American Hospital Association: On behalf of our more than 5,000 member hospitals, health systems and other health care organizations, and our nearly 43,000 individual members, the American Hospital Association (AHA) is pleased to express our support for the your legislation, H.R. 2878, which would extend through calendar year (CY) 2015 the enforcement delay on direct supervision requirements for outpatient therapeutic services provided in critical access hospitals (CAHs) and rural prospective payment system (PPS) hospitals with 100 or fewer beds. Your legislation provides immediate and critical relief to small, rural hospitals and ensures patients in these communities will continue to have access to outpatient therapeutic services. As you know, these services have always been provided by licensed, skilled professionals under the overall direction of a physician and with the assurance of rapid assistance from a team of caregivers, including a physician.

National Rural Health Association: The National Rural Health Association (NRHA), a non-profit membership organization with more than 21,000 members in rural America, strongly applauds the introduction H.R. 2878 to place a moratorium on CMS' enforcement of direct physician supervision requirements for outpatient therapy services at Critical Access Hospitals (CAHs) and other rural hospitals for 2015.  Your legislation will provide temporary relief that will go far in relieving the regulatory burden of direct supervision of outpatient therapeutic services for rural hospitals.

On Monday, July 06, 2015 at approximately 02:09 a.m. Davenport Police/Fire and Medic EMS responded to the east bound lanes of I80 mm 294 reference a single vehicle fatality crash.

The crash involved a east bound Dodge Truck with 3 adult male occupants, losing control and driving into the center median.  The Dodge lost control and rolled/flipped over with 2 of the occupants ejected from the vehicle.  2 adult males died on scene as a result of the crash including the driver, and 1 adult male was transported from the scene to Genesis East Medical Center by Medic EMS Ambulance.  He was later transported to Iowa City Hospitals and is in critical condition at this time.

Names of involved are not being released pending notification of family/next of kin.

Traffic on east bound I80 was diverted at Northwest Blvd and was closed for a short time during the investigation.  The interstate was restricted to one lane of east bound traffic until 6:30 am and then reopened.

Investigation is ongoing and is being conducted by the Davenport Police Department Crash Investigation Unit.

WASHINGTON - Sen. Chuck Grassley is asking key government agencies what they're doing to prevent and punish Medicaid dental fraud, including billing for unnecessary treatments for children, in light of inspector general audits and related media reports documenting worrisome practices.

"Some dentists are clearly performing unwanted and unneeded medical procedures on children without the consent of parents and bilking Medicaid for the privilege," Grassley wrote to Attorney General Loretta Lynch and Department of Health and Human Services Inspector General Daniel Levinson.

Grassley's letters cited Health and Human Services Office of Inspector General audits of questionable billing practices for Medicaid pediatric dental services in four states: California, New York, Louisiana and Indiana.  All of these audits identified questionable billing practices that suggest Medicaid dental providers are performing medically unnecessary procedures on children.   Grassley wrote that this conclusion has been echoed by a variety of news sources that have reported on troubling practices performed by dentists treating children in Medicaid, including a Florida-based dentist who allegedly subjected hundreds of children to unneeded tooth extractions, improper dental fixtures, and other troublesome procedures.

Grassley asked Lynch for the number of criminal and civil fraud referrals from the Health and Human Services Office of Inspector General related to Medicaid dentistry chains in the past five years, with a listing of the referrals by state and how each criminal and civil case was resolved; details of the number of ongoing Department of Justice Medicaid dental chain fraud investigations by state; and a description of the Department of Justice's plan to address the findings by the Health and Human Services Office of Inspector General that indicate health care fraud in the context of dental procedures provided to children in Medicaid.

Grassley asked Levinson for the steps the inspector general's office will take, or has already taken, to increase the auditing of dentistry offices that are recipients of federal dollars; the number of criminal and civil fraud referrals from the inspector general's office to the Department of Justice relating to Medicaid dentistry chain activity in the past five years; details of the Medicaid dentistry audits the office performed by state in the past five years, with a note on whether the audit resulted in criminal or civil referral to the Department of Justice; the number of ongoing Medicaid dental fraud investigations by state; and a description of the progress on following up on billing fraud and unnecessary procedures in Medicaid pediatric dental services.

In 2013, following a year-long investigation, Grassley and then-Finance Committee Chairman Max Baucus of Montana issued a report and recommendations urging the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care.  In 2014, the inspector general moved to disqualify a firm from Medicaid.

Grassley's latest letters are available here and here.