Session continues to move at a rapid pace and we are only two weeks away from the first funnel.

Radon

Two radon bills were introduced last week. These bills would require public schools to test for radon and mitigate if necessary. Both bills were referred to their respective Education Committee. Subcommittee members for the bills have not been named at this time. These bills must be out of full committee by February 21 to remain alive for this legislative session.

Electronic Cigarettes

Electronic cigarettes continue to be at the forefront of this session. ACS CAN is currently opposed to the bills that are before  both the House and Senate. These bills do not treat electronic cigarettes like other tobacco products and creates loopholes and special exemptions for them. The House is potentially looking at a floor vote this week. If you have not had a chance to email your House member and ask them to oppose HF2109, please do.

Day at the Capitol

Our annual Day at the Capitol is right around the corner on February 19, 2014. Iowa Insurance Commissioner, Nick Gerhart and ACS CAN's Affordable Care Expert, Dave Woodmansee will join us for our event. They will provide a state and federal update on the Affordable Care Act. If you haven't registered yet, I encourage you to do so. It is a unique opportunity to talk with your legislators and have your voice heard in the fight against cancer.

Can Mindfulness Raise Your Net Worth?
Meditative Focus Improves Both Health and Business
Intuition, Says Veteran Consultant

Sitting down with the intention of stilling one's mind and body is no longer the sole province of hippies and Eastern medicine aficionados, says leadership expert Dr. Stephen Josephs.

Nike, 50 Cent and the Marine Corps all embrace the benefits of mindfulness meditation, he says.

"The benefits of mindfulness meditation do not exist in a vacuum; mindfulness meditation not only lowers your blood pressure, it also offers a host of other positives, including increasing business acumen," says Josephs, who has coached executives for more than 30 years and recently authored the new book, "Dragons at Work," (www.DragonsAtWork.com).

"It sharpens your intuitive business sense. By relaxing your body, breathing evenly, and paying attention to the present moment, you notice things you might otherwise miss. Paying exquisite attention is the key to staying real, and daily meditation builds that capacity."

The benefits of a calm and focused mind are ubiquitous; Josephs offers tips for business leaders.

• If you're faced with what looks like an enticing opportunity, don't just do something. Sit there. Breathe quietly and let the fear and greed subside. The easiest way to fool yourself in a deal, negotiation or transaction is to let your thinking stray from what's happening and get seduced by a dream. It could be the dream your counterpart is spinning for you or simply the dream of results, good or bad. Like most people, you have probably experienced moments when you knew something - a business relationship, an investment - was going south, but you hesitated to act because you didn't have facts to support your intuition. Sometimes, your intuition knows something that your logical mind does not.

• Pay attention to what your body is telling you; you may be expressing signals that your logical mind is slow to notice. In a psychological study titled "The Iowa Gambling Task," researchers gave subjects the task of making the most money possible by choosing cards from four decks. Unbeknownst to the subjects, the decks were stacked. Some were "good decks" (producing winners more of the time) and some were "bad decks," (producing losers). After about 40 to 50 picks, most subjects caught on to which decks produced winners and losers. Their bodies knew something that their rational minds had missed. After about 10 picks they began to produce physiological symptoms of stress when their hands reached for the bad decks. If you're not paying attention to those subtle signals, your innate wisdom is inaccessible.

• Meditation develops emotional balance and a better business mind. If you've never meditated, try it! Start small by simply sitting still and keeping your eyes closed for five minutes. Feel the weight of your body in its sitting position. Try to simplify your thoughts to basic things, down to the subtle sounds of the room, your breathing. Mindfulness meditation does not require extensive study in ancient traditions. Notice the difference after only five minutes; you will feel more relaxed. Later, try it for 10 minutes, and then longer. Do your due diligence in that state of mind. The equanimity that will sharpen your acumen is also the source of your happiness in life. Don't trade it for anything.

About Dr. Stephen Josephs

With more than 30 years experience as an executive coach and consultant, Stephen Josephs, Ed. D, helps leaders build vitality and focus to make their companies profitable - and great places to work. His doctorate at the University of Massachusetts focused on Aesthetics in Education: how to teach anything through art, music, drama and movement. Josephs is particularly interested in the intersection of business performance, psychology and mind/body disciplines. His new novel, "Dragons at Work," tells the story of a tightly wound executive - a fictionalized case study of coaching that produces fundamental changes in a leader. Josephs has also co-authored "Leadership Agility: Five Levels of Mastery in Anticipating and Initiating Change" (Jossey-Bass, 2006) with Bill Joiner, which shows how certain stages of psychological development affect leadership.

In Letter To CMS Administrator Tavenner, Senators Write,  "This latest impediment has caused individuals to pay more for their insurance or to go without it, and leaves applicants with almost no recourse to fix their problems."

WASHINGTON - Today, U.S. Senators Orrin Hatch (R-Utah), Lamar Alexander (R-Tenn.), Chuck Grassley (R-Iowa), and Mike Enzi (R-Wyo.) wrote to Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner seeking answers on how the agency will process appeals when Americans attempting to enroll in the ObamaCare exchanges through HealthCare.gov are denied coverage due to technical errors.

Earlier this week, the Washington Post reported that roughly 22,000 individuals had appealed HealthCare.gov's mistakes when they were signing up for insurance. However, CMS does not have the appropriate technology in place to manage appeals. Questioning whether the agency will be able to resolve these appeals promptly and efficiently, the Senators asked CMS to provide details on how long it will be before the technical infrastructure is properly functioning and requested information on the appeals process that is currently in place.

"As Americans continue to endure the badly botched rollout of a website that cost taxpayers hundreds of millions of dollars, we learned recently that thousands of applicants have been unable to correct mistakes on their insurance applications and that CMS does not have a system in place to resolve these mistakes," wrote the Senators. "This latest impediment has caused individuals to pay more for their insurance or to go without it, and leaves applicants with almost no recourse to fix their problems."

Hatch is the Ranking Member of the Senate Finance Committee, Alexander is the Ranking Member of the Senate Health, Education, Labor and Pensions (HELP) Committee, Grassley is the Ranking Member of the Senate Judiciary Committee, and Enzi is the Ranking Member of the Senate HELP Subcommittee on Children & Families.

The text of the letter to Administrator Tavenner is below and a signed copy can be found HERE:

February 6, 2014

The Honorable Marilyn Tavenner

Administrator

Centers for Medicare & Medicaid Services

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Washington, DC  20201

Dear Administrator Tavenner:

We are writing to request information about how the Centers for Medicare & Medicaid Services (CMS) plans to reconcile the mistakes that have been generated in the healthcare.gov application process. As Americans continue to endure the badly botched rollout of a website that cost taxpayers hundreds of millions of dollars, we learned recently that thousands of applicants have been unable to correct mistakes on their insurance applications and that CMS does not have a system in place to resolve these mistakes. This latest impediment has caused individuals to pay more for their insurance or to go without it, and leaves applicants with almost no recourse to fix their problems.

The Washington Post reported this week[1] that 22,000 people have appealed to CMS to try to correct mistakes on their insurance applications filed through the federal health exchange. Our understanding is that most of the mistakes were caused by the website and not the individuals. For example, some people who need health insurance are not getting the full subsidy to which they are entitled. Others found that their applications had obvious mistakes, like declaring one of their children eligible for the Children's Health Insurance Program (CHIP) and the other one ineligible. Others became stuck in a never-ending loop when the exchange found them ineligible for exchange coverage because they were eligible for Medicaid, but their state disagreed. These consumers have legitimate complaints and their concerns should be remedied as expeditiously as possible by your agency.

However, according to the Post, CMS does not have a system in place to resolve these appeals. While this in itself is perplexing, the article further states that CMS has no plans to develop the appeals system in the near future. Like other "back-end" systems?such as the technology that sends enrollees' information to insurance companies through "834" electronic forms?the automated appeals system has not yet been constructed. Instead, people are directed to file appeals by mail, a more time-consuming process that could result in the denial of necessary care, or to delete their online profiles and start over, only to find themselves back in the same predicament. All of this is because the technology that would allow CMS staff to handle appeals has not been built.

CMS' intention to initiate hearings for some of the affected appellees is a step in the right direction, but generally, hearings do not result in timely resolution.  Healthcare.gov's website states that "In general, we must tell you our decision and mail our response within 90 days of when we received your appeal request."[2] Ninety days or more is unacceptable to the thousands of Americans who may have their care interrupted, or be unable to insure themselves or their children, while they are waiting to have the issues with their application resolved. The challenges faced by these individuals should be investigated and promptly resolved by the appropriate officials. A seven-page form, followed by investigative hearings, is a burdensome process to resolve what are reportedly technical "glitches" that the affected individual had no part in creating.

 

We collectively are concerned about whether or not participants in the exchanges will have their problems resolved promptly and efficiently.  To help us better understand how CMS intends to assist those negatively impacted by the healthcare.gov website, please provide us with answers to the following questions:

 

1.       Which division within CMS is responsible for managing exchange-related appeals and which division had the ultimate responsibility for overseeing the development and operational functionality of the exchange appeals process?

2.       How many healthcare.gov appeals has CMS addressed and resolved to date?

3.       What is the schedule for resolving the current backlog of appeals?

4.       How long does CMS anticipate it will take to resolve the average appeal and how is CMS communicating to appellees about the length of time for resolution of their appeals?

5.       What is the timeline for building the infrastructure necessary to route appeals to the proper channels so that CMS officials can address their needs and resolve them expeditiously?

6.       When will consumers be able to file appeals by phone or electronically?

7.       What is CMS' rationale for not including the appeals infrastructure in the initial phase of the Federal exchange functionality?

8.       Why was a contingency plan for handling appeals not developed sooner given the lack of infrastructure to handle appeals that was present from the launch of the exchanges onward?

We remain concerned that CMS has continued to over promise and under deliver. We urge you to carefully consider the above issues and to provide a written response to our questions by February 28, 2014.

Sincerely,

HATCH
GRASSLEY
ALEXANDER
ENZI

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BETTENDORF, Iowa - Feb. 6, 2014 - Genesis Health System announced today it will invest $15 million in the future of health care in the region at the new Genesis HealthPlex, Bettendorf.

The second Genesis HealthPlex - the first opened in November in Moline -- will give patients "one stop'' access to many health services. Genesis HealthPlex, Bettendorf is under construction at 2140 53rd Ave., Bettendorf. The HealthPlex is adjacent to ORA Orthopedics and the Genesis Center for Digestive Health.

Genesis Health Group President Richard Kishiue, M.D., said the new facility is recognition of the national trend to provide more health care services outside of a hospital setting.

"Like Genesis HealthPlex, Moline, the Genesis HealthPlex, Bettendorf will be able to provide virtually all of the health services now available at multiple sites, from primary care physicians, to radiology, laboratory, specialists and Genesis Convenient Care,'' Dr. Kishiue said.

The 43,140-square foot HealthPlex is under construction and will be open to patients late in 2014. Estes Construction of Davenport is the general contractor.

Genesis HealthPlex, Bettendorf is an IMPACT construction project using local skilled trades.

With a focus on providing care to more patients in the future, four graduates of the Genesis Quad Cities Family Medicine Residency Program will start their practices in the new facility.

"We understand the concerns about access to a primary care physician as thousands more residents of the region will have health insurance under the Affordable Care Act and will develop a relationship with a physician,'' Dr. Kishiue added. "Genesis has been very aggressive in recruiting new primary care physicians and specialists and will continue to be aggressive in our recruiting to make sure the newly insured are able to establish a relationship with a primary care physician rather than using emergency departments as their gateway for health services.''

The four recent residency program graduates who will base their new practices at Genesis HealthPlex, Bettendorf are Stacie Salowitz, M.D., a University of Iowa medical school graduate; Sheena Harker, who received her undergraduate degrees at Augustana College and received her medical degree from Des Moines University College of Osteopathic Medicine; Catherine Schierbrock, M.D., a University of Iowa medical school graduate; and, Ryan Boone, M.D., who received his medical degree from Destiny University School of Medicine, St. Lucia.

Linda Jager, M.D., is a fifth graduate of the Genesis Quad Cities Family Medicine Residency Program who has already joined Genesis Health Group.

Chris Crome, M.D., and Kurt Andersen, M.D., will move their practices from other Genesis Health Group locations and will serve as mentors for the recent residency graduates. Genesis Convenient Care will be moving from Devils Glen in Bettendorf to the new location.

"The support of Genesis Health Group physicians is one of the reasons we've been able to develop this plan,'' Dr. Kishiue said. "Usually we would only be able to retain one or two of the new doctors from the residency program. Being able to recruit five in one year is unheard of for us.

"The collaborative approach of experienced doctors and new doctors emphasizes how important we believe it is for newly insured patients to have a health and wellness relationship with a primary care doctor.

"That is how the Affordable Care Act will work effectively and not only will the health of the region improve, care will be more efficient as services are consolidated at a single site.''

Genesis HealthPlex, Bettendorf will have a full-service lab, digital imaging, including MRI, CT, radiography, ultrasound and mammography. There will be space for 18 providers, 65 examination rooms, nine procedure rooms and two education rooms.

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