Health care tax rules trip up some immigrants

The deadlines coming to file tax returns, and aside from the usual headache, this year its proving particularly thorny for undocumented immigrants. Thats because, for the first time, there are penalties under the Affordable Care Act for those lacking health insurance.

But the law is complex, and when it comes to people living in the U.S. illegally, many are getting slapped with fines they shouldnt have to pay.

Adalberto Martinez, a mechanic at an auto body shop in Chicago, is one of them. Like many undocumented immigrants, Martinez pays income taxes, using an IRS-issued taxpayer identification number, called an ITIN. But this year, he noticed something different when he sat down with his tax preparer.

They told me that theres a box where you have to answer whether you have insurance or not, he explained in Spanish. So she put down that I didnt have insurance. She didnt explain to me exactly why, just that there was a box there and I didnt have insurance.

Afterwards, Martinez found he was hit with a $200 fine for not having health coverage in 2014. The official name for the penalty was the shared responsibility payment.

Most lawful U.S. residents are required to have health coverage under Obamacare, and those who dont will have to pay the penalty. But under the law, undocumented U.S. residents, like Martinez, are exempt from all that. But Martinezs story is not unique.

Weve heard from at least 10 to 15 organizations that have been hearing this issue in the community, said Luvia Quinones, health policy director at the Illinois Coalition for Immigrant and Refugee Rights.

Quinones said its not clear how many undocumented immigrants may have improperly paid the fine, but she said thousands in Illinois could be at risk.

We know that in the state of Illinois, theres about 310,000 undocumented, uninsured individuals in addition to about 70-80 thousand DACA youth that are eligible also to get their work permit, she said.

DACA youth, also known as DREAMers, are immigrants that arrived in the U.S. as children and obtained temporary relief from deportation under President Obamas Deferred Action for Childhood Arrivals program. They have valid Social Security numbers, which could be used to file tax returns. This puts them at particular risk for mistaken penalties, because while their Social Security numbers may suggest that they are lawful U.S. residents, and therefore subject to the health care penalty, Obamacare explicitly excludes them from the health coverage requirement.

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Health care tax rules trip up some immigrants

Health care professionals charged in 'Medicaid mill' scam

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Health care professionals charged in 'Medicaid mill' scam

A practical solution to Texas health care delivery crisis

With about one in four uninsured, Texas ranks last in the number of residents with health insurance. This dubious distinction coupled with poor utilization of limited professional resources further compounds the delivery of health care to a rapidly growing population. Additionally, despite low reimbursement rates for Medicaid providers, Texas Medicaid budget continues to grow.

One way to address the access and budgetary health care crisis is to restructure the medical matrix to more efficiently utilize currently available resources in our provider system. Granting full practice authority to advanced practice registered nurses (APRNs) would go a long way toward alleviating the crisis.

We filed S.B. 751 and H.B. 1885 to allow APRNs to practice to the full extent of their education and clinical capability, providing much needed access to primary care. Texas APRNs are already providing critical health care functions, including evaluating and diagnosing patients; ordering and interpreting diagnostic tests; and initiating and managing treatments, including prescribing medications. This legislation would authorize them to continue these activities, but would eliminate needless statutory and regulatory mandates that limit their ability to practice, particularly in rural areas.

Under current Texas law, APRNs can only prescribe medication under the authority delegated by physicians, and they must meet face-to-face with a supervising physician periodically. With few physicians opting to practice in rural areas, this requirement prevents many APRNs from providing care in these underserved settings.

Because Texas requires delegation, we are losing APRNs to the 20 states and the District of Columbia, where APRNs have full practice authority. The New Mexico Legislature appropriated funds to the New Mexico governor specifically to recruit APRNs from Texas. Every year, tens of millions of Texans taxpayer dollars go to educating APRNs. However, we are not reaping the benefits of our investment because states like New Mexico recruit our APRNs away to address their provider shortages. We cannot afford this drain on our resources.

Texas currently ranks 42nd in the U.S. in the ratio of physicians per population and 47th in the ratio of primary care physicians. In rural areas, the primary care shortage is even worse; 185 of our states 254 counties are medically underserved.

Opponents claim this legislation runs counter to the trend of team-based practices. However, with full practice authority, APRNs will continue to collaborate with physicians and other health care providers.

Texas currently has more than 18,000 licensed APRNs today whose vast expertise is not being fully utilized. Allowing APRNs to practice to the full extent of their education and clinical capability will not only provide access to much needed care but will do so without creating huge costs. APRNs perform many of the same functions physicians perform, but more cost-effectively and without compromising quality of service. The average cost of treatment by an APRN is 20 to 35 percent lower than that of a physician.

Opponents of this legislation argue that APRNs dont have as much education and training as doctors and say that extending full practice authority to them is a public safety concern. Hundreds of studies conducted over the past 40 years highly rated on strength of evidence have repeatedly found APRNs care to be equivalent, and in some cases superior, to that provided by physicians.

Chronic disease and health disparities among Texas rapidly expanding and aging population is an increasing concern, especially when fewer medical school graduates are choosing primary care practice (only nine percent in 2009). In contrast, 80 percent of our APRNs work in a primary care setting. An adequate primary care workforce is essential to providing quality, affordable health care.

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A practical solution to Texas health care delivery crisis

Advocate Health Care acquires land for medical offices in Huntley

HUNTLEY Advocate Health Care plans to build a new medical office building in Huntley, after the regional medical provider recently acquired six undeveloped acres near the Interstate 90 interchange, a property developer said.

Phillip Waters, vice president of development for Horizon Group, told the Northwest Herald that Horizon closed on the deal with Advocate earlier this winter.

Advocate plans to start construction on the new office building by the fall, as one of its competitors Centegra Health System continues to build a new hospital located on the north end of Huntley.

We are very excited to have them a part of the Huntley community, Waters said. Advocate is the largest health care provider in the state and a premier provider across the nation.

The six vacant acres are near the Huntley Corporate Park on the northwest corner of the I-90 interchange. Waters said he did not know Advocates specific plans for the area.

The health care provider paid fair market value for the vacant land, although Waters did not disclose the terms of the deal. An Advocate spokesperson did not return a request for comment Monday.

Advocates acquisition also follows Life Spine Inc.s recent move to Huntley. The medical device company in 2014 announced plans to move its corporate headquarters into a larger facility near the I-90 interchange.

Advocates medical office building would be located next to the Life Spines new headquarters, Waters said.

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Advocate Health Care acquires land for medical offices in Huntley

Health Care Sector Update for 03/30/2015: ADMP,ICEL,BDSI

Top Health Care Stocks

JNJ +1.19%

PZE +1.35%

MRK +0.64%

ABT +0.92%

AMGN +0.82%

Health care stocks were higher in afternoon trade, with the NYSE Health Care Sector Index rising 1.1% and shares of health care companies in the S&P 500 up 0.9% as a group.

In company news, Adamis Pharmaceuticals Corp ( ADMP ) tumbled Monday after saying federal regulators have sent a Complete Response Letter to the drugmaker's new drug application for its prospective single-use epinephrine injection for acute allergic reaction.

According to the company, the U.S. Food and Drug Administration's questions only pertain to the dosing volume delivered by the syringe, including the levels contained in the drug's labeling claims and as required by the FDA.

No other safety or efficacy issues were raised by the agency, which is keeping the company's new drug application open during the review.

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Health Care Sector Update for 03/30/2015: ADMP,ICEL,BDSI