Urges Congress Research Articles

MH Experts Urge Congress to Act on Maternal Mortality

MH Experts Urge Congress to Act on Maternal Mortality

219 Economists, Law Professors & Other Academics Urge Congress to Include the 'Billionaires Income Tax' in Build Back Better Act

219 Economists, Law Professors & Other Academics Urge Congress to Include the 'Billionaires Income Tax' in Build Back Better Act

APA Experts Urge Congress to Continue Relaxed Telehealth Regulations Post-Pandemic

APA Experts Urge Congress to Continue Relaxed Telehealth Regulations Post-Pandemic

Soldiers with Fortunes? Rethinking the Tax Treatment of Fallen Combatants

From the Revolutionary War to the battle against international terrorism, American history has been shaped by military conflict. That national history also reflects an ongoing effort to thank those who have served in our nation’s armed forces and to honor those who have fallen in combat. Like much in our national consciousness, such as our desires to incentivize energy efficiency, higher education, and home ownership, our quest to honor our fallen heroes has shaped modern tax policy. The tax code contains a litany of tax relief provisions targeted toward members of the nation’s military, including statutes providing relief from income and estate taxes for those who die in combat operations. In this article, I explore the origins, justification and operation of the estate tax relief offered to those who fall in combat (hereinafter the “combat exemption” or “the estate tax exemption”), currently codified in Section 2201 of the Internal Revenue Code (hereinafter “the Code”). I contend that while well-intentioned, the combat exemption is a poorly-targeted provision that does little to address the plight of those left behind by our fallen heroes. I urge Congress to abandon the provision and instead to offer greater, simplified, income tax relief to the families of those lost in combat.

Make Your Voice Heard: ‘Engage 2014’

Make Your Voice Heard: ‘Engage 2014’

All In with Jack High

In United States v. DiCristina, the Eastern District of New York ruled that Texas Hold ‘Em poker is game of skill, and thus, not illegal under the federal Illegal Gambling Business Act. In the decision, the court found that the statute’s text and legislative history did not indicate that Congress intended to include Texas Hold ‘Em poker amongst other illegal gambling activities. But most importantly, the Eastern District found that the analytical and psychological elements of the game allow a skilled player to perform better than another. This, the court reasoned, differentiated Texas Hold ‘Em poker from other types of illegal gambling activities. Though the Second Circuit Court of Appeals ultimately disagreed on statutory interpretation grounds, the Eastern District’s skill analysis still stands and gives credence to the longstanding argument that the game, because it allows skilled players to excel over non-skilled players, sits on its own compared to prohibited gambling activities. In effect, DiCristina laid the foundation and answered one of the last remaining questions keeping Congress from legalizing online Texas Hold ‘Em poker. This Comment will explore various legalization surges throughout America’s history of gambling that ultimately helped push forward new periods of regulation and reform. This Comment will also examine the rise and fall of internet gambling and the current federal laws keeping the once thriving industry from returning. Additionally, this Comment will look at prior conclusions of the skill-versus-chance argument before DiCristina, and the Eastern District’s approach to resolving the skill versus chance issue. Lastly, this Comment will examine recent developments surrounding online Texas Hold’ Em poker that mirror surges of prior periods of reform, and together with DiCristina, urge Congress to use these final strongholds to advance federal legislation allowing for interstate online Texas Hold ‘Em poker.

Health IT Group Urges Congress to Uphold Incentives

Health IT Group Urges Congress to Uphold Incentives

Table of Contents

AbstractKansas Advocates Seek to Change Biased Mental Health Language in ConstitutionPhiladelphia MH Agency Demonstrates Collective Power of Modest ChangesMo. Budget Woes Force Providers to Collaborate, Find New FundingField Urges Congress to Press Forward on Passing HC Reform BillInterim Final Rules Under the Federal Parity Act Released This WeekSAMHSA Makes Temporary Funds Available for Families Needing MH TreatmentBriefly NotedState NewsNames in the NewsCall for ApplicationsCall for AbstractsObituaryComing up

Committee Urges Congress, HHS to Fund Medical Homes

Committee Urges Congress, HHS to Fund Medical Homes

APS Urges Congress and White House to Revisit Fiscal Year 2008 Science Funding in January

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Payment Confusion

To the Editor.—The recent article by Melzer et al1 is an eye-opener! It illustrates the confusing collage of payment and reimbursement schemes now in use in the United States. One could argue that their analysis is inadequate because it is limited to an academic institution. However, the “academic overhead” of 24% they cited is less than half that of most private practices, which makes the authors financial conclusions that much more frightening. Clearly, providing pediatric care in the present financial context is a “losing proposition.”What to do? The current alphabet soup system of resource-based relative value scales, total relative value limits, conversion factors, Current Procedural Terminology codes, and so forth should be scrapped. That the authors urge practitioners to spend time learning Current Procedural Terminology codes instead of caring for children illustrates this insanity.Instead, pediatricians and other care providers should bill and be paid on a strictly hourly basis. This would be similar to attorneys, who typically bill by the tenth of an hour, be it court, travel, telephone, or consultative time. We should do the same. I suggest charging $200 for each hour of our time. The Academy should investigate this possibility and urge Congress to change federal physician payment methods.In Reply.—We appreciate Dr Haruda’s thoughtful comments, and his letter clearly highlights certain critical problems in the current system of reimbursement for physician services. The extraordinary (and growing) number of Current Procedural Terminology (CPT) codes, along with the complexity of unique documentation requirements for each code, represents a significant barrier to physicians seeking to accurately report, and obtain fair reimbursement for, their work.The notion of reimbursement based on time spent with the patient as suggested represents a credible alternative to the current system of evaluation and management (E&M) codes. Proponents of a time-based system of reimbursement argue that this method best represents the value of physician work, and note that such a system would greatly simplify reporting, documentation, and auditing of medical services.The American Academy of Pediatrics (AAP) Committee on Coding and Reimbursement (COCR) continues to discuss this option. Time-based reimbursement is also being advanced by segments of the internal medicine and family practice communities, through the American College of Physicians—American Society of Internal Medicine and American Academy of Family Physicians, respectively. We suggest that practitioners who feel similarly contact COCR or their professional associations to provide support for this move away from burdensome documentation and paperwork requirements.We support additional investigation into the feasibility of time-based codes for inpatient care, especially given the minimal amount of “overhead” or practice expense that is involved in inpatient service delivery compared to office based E&M services. However, we also acknowledge the reality that any change in CPT in this direction will take a long time, and therefore one purpose of our article1 is to educate physicians trying to work within the current CPT system. We have emphasized the importance of accurate coding to ensure that physicians are fairly compensated for the time they spend in providing inpatient care. In contrast to many office-based services, the current coding system for inpatient services is relatively straightforward, both in terms of number of possible codes and documentation requirements, and as such lends itself well to the use of coding templates. In our experience, the use of coding templates improves the accuracy of physician coding and reimbursement. These templates also provide the added benefit of improved patient care, both through better documentation and by freeing up time to allow the physician to concentrate on the most important task at hand—the care of a sick hospitalized child.

As Nursing Shortage Nears Crisis Stage, ONS Urges Congress to Act

As Nursing Shortage Nears Crisis Stage, ONS Urges Congress to Act

Defense Contingency Budgeting in the Post-Cold-War World

One of the major government reform initiatives in the industrialized democracies in the 1990s has been the new public management. In the United States, the initiative gained considerable attention when a report issued by a commission chaired by Vice President Al Gore endorsed the development of performance-based measures in government. As prescribed by the National Performance Review (NPR, 1993), agencies should be freed from the red tape of detailed specifications and by Congress. Instead, agencies should be given goals and performance objectives (Thompson, 1991; Meyer and Khademian, 1996). Among the prescriptions of the National Performance Review are recommendations to implement mechanisms that would provide greater flexibility in budgeting processes, particularly in the area of national security. Ex post contingency budget execution in defense already provides considerable flexibility for defense spenders--as we illustrate by a case study of the financing of United States involvement in Bosnia. Yet, the spending discretion that has sustained U.S peace-keeping in Bosnia is quite different from, and in some respects antithetical to, the flexibility championed by advocates of the new public management. The message that this article conveys, based on our analysis of the Bosnia experience, is that neither the current system for funding defense contingencies nor the proposals of the new public management achieve the goals of providing accountable and effective mechanisms for funding these operations. Thus we offer modest proposals for reform that may make changes akin to those of the new public management compatible with traditional forms of budget execution. If implemented, the new mechanisms could permit the executive and legislative branches to focus on the policy questions inherent in post-cold-war military contingencies. At present the minutiae of the budget process serves as a lightning rod to prompt debate and diverts attention from a priori policy questions. The proposals outlined would reverse this situation. The New Public Management and Budgeting in Defense One of most provocative applications of the new public management to defense is by Thompson and Jones (1994). Instead of micromanagement of the defense budget through line items in appropriations, restrictive appropriations, and endless reporting, advocates of the new public management urge Congress to return to its classic role as the deliberator of important policy issues related to spending, programs, and strategy. Mission budgeting is central to the reforms suggested by Thompson and Jones. As part of the broader decentralization of the Pentagon, where performance measures replace detailed prescriptions and rigid compartmentalization of budgets and spending, mission budgeting would, they concede, require significant changes in the law and practice of national security appropriations. Under mission budgeting, when the Department of Defense appropriations are enacted by Congress, obligation authority would be given to mission centers, or joint operational commands, rather than to the military services. The accounts funded would thus be mission accounts rather than department accounts. To make this change more than merely cosmetic, however, Thompson and Jones advocate implementing the recommendations of the National Performance Review to increase the Pentagon's discretion to transfer funds between accounts and across fiscal years. Thus, congressional budgeting for defense should be, in their words, permissive, continuous, and selective [and] focus on all of the cash that ensue from Congress's programmatic choices ... new obligational authority should be expressed in terms of the discounted present values of those cash flows (Thopmson and Jones, 1994, 233). They would de-emphasize the annual budget resolution, do away with the president's budget, and focus attention on the decision to go ahead with a program or activity. …

Policy Disputes as a Source of Administrative Controls: Congressional Micromanagement of the Department of Defense

Is congressional micromanagement an unwarranted and inappropriate intrusion into the operations of the federal bureaucracy? Focusing on congressional oversight of the Defense Department, Kenneth R. Mayer shows that budgetary and administrative micromanagement are legislative tools for achieving policy preferences within DoD. He argues that calls for reform of micromanagement must take the policy making prerogatives of Congress into account. Congressional activity on the defense budget-line-item changes, programmatic restrictions, requests for reports and information-is often criticized as micromanagement. Micromanagement is viewed as an inappropriate intrusion by Congress into executive branch affairs, and is said to result in inefficiency. Critics of micromanagement urge Congress to return to a policy-focused view of the defense budget, in which reviews of national security strategy and requirements would replace program-level and management instructions. In doing so, Congress would return to its proper role of overseer of national policy and would vastly increase the efficiency with which the defense budget could be managed.

AIBS Report: AIBS Director Urges Congress to Keep Biology Research Healthy

AIBS Report: AIBS Director Urges Congress to Keep Biology Research Healthy

Universities Do Too Much Research: Expand Industrial Research, President Urges Congress

Universities Do Too Much Research: Expand Industrial Research, President Urges Congress