Q&A: What Can IRS Do to Health Plan Scofflaws?

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The new health care law helps some people, hurts others and confuses almost everyone. Hoping to simplify things a bit, The Associated Press asked its Twitter, Facebook and Google Plus followers for their real-life questions about the program and the problems they're running into as the March 31 deadline approaches to sign up for coverage in new insurance markets.

Two of their questions and AP's answers.

THE INTERNAL REVENUE SERVICE AND ME

Q: "Is it really true that the IRS can't do anything to you if you refuse to get insurance and also refuse to pay the penalty?" David Myer, 46, a consulting geophysicist in Encinitas, Calif.

A: You could say the IRS has one hand tied behind its back here. But that still leaves the other hand. The tax collectors don't have nearly as many tools to go after insurance avoiders as it has to enforce tax laws. It can, however, dip into people's tax refunds to collect the penalty for those who don't get health insurance. Most filers qualify for a tax refund, so they would be exposed to that collection tactic. Beyond that, it can send insistent letters, and who wants to get those?

Elizabeth Maresca, a former IRS trial attorney, told the AP that an unfriendly letter about an outstanding health insurance penalty probably will have much the same effect as one about tax arrears. "Most people pay because they're scared, and I don't think that's going to change," she said.

That said, the IRS can't seize bank accounts, dock wages, charge interest on unpaid penalties or apply criminal or civil sanctions to force people to obtain health coverage.

CAN I JOIN THE EXCHANGE?

Q: "Why are there limits as to who can sign up? If someone has an employer plan that they don't like, they can't switch the plan to one of the new ones." Duane E. Maddy, a graphic designer and digital artist in Dunbar, W.Va.

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Q&A: What Can IRS Do to Health Plan Scofflaws?

Consolidation could fuel costly trend on health care prices

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BOSTON -- The drivers of health care costs in Massachusetts - provider price increases, the gap between high and low paid providers and the volume of care delivered in high-price settings - have been identified consistently by researchers over the past five years as policymakers have grappled with how to slow cost growth, according to a new analysis.

If the themes sound familiar, it's because they have been repeatedly flagged by state agencies trying to understand what is behind the high cost of health care in Massachusetts.

An analysis of state reports conducted since 2008, performed for the Massachusetts Association of Health Plans, identified 10 recurring factors that have contributed to rising costs for employers and consumers. Among them, researchers found that health care is most often delivered in high-price settings that don't necessarily correlate to a greater quality of care.

Academic medical centers tend to be associated with higher health care costs, and a significant gap has continually been observed between the highest and lowest paid providers, while those hospitals and clinics with the lowest reimbursement rates tend to treat the highest volume of patients on Medicare and Medicaid.

The report, to be released Monday and compiled by Freedman HealthCare, reviewed 16 cost trend reports, including studies done by the Division of the Insurance, the Attorney General's office, the Center for Health Information and Analysis (formerly the Division of Health Care Finance and Policy) and the Health Policy Commission.

"We're seeing so many changes now in the Legislature and we're going to have a new governor in January and we're continuing to see the same trends over and over and hearing the same things so it's important to focus and monitor to see if we're making progress," said Lora Pellegrini, president of the Massachusetts Association of Health Plans, a trade group that represents the interest of insurers.

Provider pricing and the impact of market clout in price negotiations with insurers have emerged in recent years as a focal point for lawmakers and regulators who are seeking to find ways to limit cost growth in an industry where prices were heavily regulated before passage of an early 1990s deregulation law.

"The large provider organizations are not only large in terms of volume but because they tend to be market dominant they demand higher prices," said John Freedman, a physician who has also worked for Tufts Health Plan and conducted the analysis of the state reports.

In negotiations, providers and payers have become "sensitive" to the cost growth benchmarks established by a new law in 2012, but "there's nothing to suggest that these kinds of trends couldn't continue to happen," said Pellegrini.

Freedman said increasing provider prices has led to higher health care premiums and consumer cost sharing.

Originally posted here:

Consolidation could fuel costly trend on health care prices

Supreme Court takes up Hobby Lobby health care case Tueday

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A challenge to part of President Barack Obama's health care law that hits the Supreme Court on Tuesday could lead to one of the most significant religious freedom rulings in the high court's history.

Four years ago, in their controversial Citizens United decision, the justices ruled that corporations had full free-speech rights in election campaigns. Now, they're being asked to decide whether for-profit companies are entitled to religious liberties.

At issue in Tuesday's oral argument before the court is a regulation under the Affordable Care Act that requires employers to provide workers a health plan that covers the full range of contraceptives, including morning-after pills and intrauterine devices, or IUDs.

The Supreme Court will hear arguments Tuesday in a religion-based challenge from family-owned companies that object to covering certain contraceptives in their health plans as part of a preventive care requirement. Among them, Hobby Lobby Stores Inc. is the largest. (AP Photo/Ed Andrieski, File)

The evangelical Christian family that controls Hobby Lobby Stores Inc., a chain of more than 500 arts and crafts outlets with 13,000 workers, says the requirement violates its religious beliefs.

Some contraceptives can "end human life after conception," the Green family says. Forcing the owners to pay for such devices would make them "complicit in abortion," their lawyers say.

A ruling in their favor could have an effect on tens of thousands of women whose employers share the Greens' objections to some or all contraceptives.

But the case could also sweep far beyond just this one provision of Obamacare. The justices have been wary of accepting claims that religious beliefs can exempt people -- or companies -- from following laws that apply to everyone. The court's previous religious freedom cases usually involved narrowly focused claims from religious minorities, such as the Amish or Seventh-day Adventists.

But the current court, led by Chief Justice John G. Roberts Jr., has shown a greater interest in religious freedom claims. And because the objections to the contraceptive mandate come from Catholic bishops and evangelical Christians, not small or obscure sects, the potential effect has been magnified.

The Obama administration argues that if the justices allow Hobby Lobby to refuse to pay for contraceptives because of its owners' religious beliefs, the way would open for religious objections to a broad array of laws. Companies potentially could shape the benefits they offer, and perhaps even their hiring, based on their religious convictions.

Continued here:

Supreme Court takes up Hobby Lobby health care case Tueday

Q&A: Who can shop online for health coverage?

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Originally published March 24, 2014 at 5:35 AM | Page modified March 24, 2014 at 1:10 PM

The new health care law helps some people, hurts others and confuses almost everyone. Hoping to simplify things a bit, The Associated Press asked its Twitter, Facebook and Google Plus followers for their real-life questions about the program and the problems they're running into as the March 31 deadline approaches to sign up for coverage in new insurance markets.

Two of their questions and AP's answers.

THE INTERNAL REVENUE SERVICE AND ME

Q: "Is it really true that the IRS can't do anything to you if you refuse to get insurance and also refuse to pay the penalty?" -- David Myer, 46, a consulting geophysicist in Encinitas, Calif.

A: You could say the IRS has one hand tied behind its back here. But that still leaves the other hand. The tax collectors don't have nearly as many tools to go after insurance avoiders as it has to enforce tax laws. It can, however, dip into people's tax refunds to collect the penalty for those who don't get health insurance. Most filers qualify for a tax refund, so they would be exposed to that collection tactic. Beyond that, it can send insistent letters, and who wants to get those?

Elizabeth Maresca, a former IRS trial attorney, told the AP that an unfriendly letter about an outstanding health insurance penalty probably will have much the same effect as one about tax arrears. "Most people pay because they're scared, and I don't think that's going to change," she said.

That said, the IRS can't seize bank accounts, dock wages, charge interest on unpaid penalties or apply criminal or civil sanctions to force people to obtain health coverage.

___

CAN I JOIN THE EXCHANGE?

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Q&A: Who can shop online for health coverage?

UPDATE: Health Care, Tech Names Lead Decline in U.S. Stocks

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NEW YORK Weakness in the health care and technology sectors dragged the U.S. stock market lower.

Health care stocks, which have risen more than other industries over the past year, fell sharply on Monday.

Pfizer had the biggest loss in the Dow Jones industrial average, 2 percent. Biotech stocks continued a decline that began Friday after lawmakers questioned the pricing of a Hepatitis C drug.

The Standard & Poor's 500 index fell nine points, or 0.5 percent, to close at 1,857.

The Dow lost 26 points, or 0.2 percent, to 16,276.

The technology-heavy Nasdaq composite fell 50 points, or 1.2 percent, to 4,226.

Facebook, which has more than doubled over the past year, fell 5 percent.

Bond prices rose. The yield on the 10-year Treasury note fell to 2.73 percent.

Health care stocks, which have risen more than other industries over the past year, fell sharply on Monday.

Pfizer had the biggest loss in the Dow Jones industrial average, 2 percent. Biotech stocks continued a decline that began Friday after lawmakers questioned the pricing of a Hepatitis C drug.

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UPDATE: Health Care, Tech Names Lead Decline in U.S. Stocks

Genetic test could show which babies will have low IQ

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Lead researcher Dr Peter Taylor, from the University of Cardiff's School of Medicine, said: "If other studies confirm our finding then there may be benefit in carrying out a genetic test for this gene variant in addition to the standard neonatal thyroid screening, which would identify children most at risk of developing low IQ.

Around 4 per cent of the population have the gene variant coupled with a lower than normal thyroid hormone levels.

The finding could mean that up to 2.5 million people in Britain could be suffering from the effects of low IQ which might have been treatable.

The new research focused on an enzyme called deiodonase-2 which is involved in processing thyroid hormones within cells.

A mutation in the gene coding for the enzyme had already been associated with other health problems including diabetes and high blood pressure.

In the new study, scientists from the universities of Cardiff and Bristol looked at genetic data on 3,123 children under the age of seven who also had their IQ tested.

Those with thyroid hormone levels at the bottom of the normal range who also possessed the deiodonase-2 variant were four times more likely to have an IQ under 85.

Children with lower thyroid hormone levels alone were not at greater risk of low IQ.

The findings were presented at the Society for Endocrinology's British Endocrine Societies (BES) conference in Liverpool.

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Genetic test could show which babies will have low IQ

From mouse ears to human's? Gene therapy to address progressive hearing loss

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One in a thousand children in the United States is deaf, and one in three adults will experience significant hearing loss after the age of 65. Whether the result of genetic or environmental factors, hearing loss costs billions of dollars in healthcare expenses every year, making the search for a cure critical.

Now a team of researchers led by Karen B. Avraham of the Department of Human Molecular Genetics and Biochemistry at Tel Aviv University's Sackler Faculty of Medicine and Yehoash Raphael of the Department of Otolaryngology-Head and Neck Surgery at University of Michigan's Kresge Hearing Research Institute have discovered that using DNA as a drug -- commonly called gene therapy -- in laboratory mice may protect the inner ear nerve cells of humans suffering from certain types of progressive hearing loss.

In the study, doctoral student Shaked Shivatzki created a mouse population possessing the gene that produces the most prevalent form of hearing loss in humans: the mutated connexin 26 gene. Some 30 percent of American children born deaf have this form of the gene. Because of its prevalence and the inexpensive tests available to identify it, there is a great desire to find a cure or therapy to treat it.

"Regenerating" neurons

Prof. Avraham's team set out to prove that gene therapy could be used to preserve the inner ear nerve cells of the mice. Mice with the mutated connexin 26 gene exhibit deterioration of the nerve cells that send a sound signal to the brain. The researchers found that a protein growth factor used to protect and maintain neurons, otherwise known as brain-derived neurotrophic factor (BDNF), could be used to block this degeneration. They then engineered a virus that could be tolerated by the body without causing disease, and inserted the growth factor into the virus. Finally, they surgically injected the virus into the ears of the mice. This factor was able to "rescue" the neurons in the inner ear by blocking their degeneration.

"A wide spectrum of people are affected by hearing loss, and the way each person deals with it is highly variable," said Prof. Avraham. "That said, there is an almost unanimous interest in finding the genes responsible for hearing loss. We tried to figure out why the mouse was losing cells that enable it to hear. Why did it lose its hearing? The collaborative work allowed us to provide gene therapy to reverse the loss of nerve cells in the ears of these deaf mice."

Although this approach is short of improving hearing in these mice, it has important implications for the enhancement of sound perception with a cochlear implant, used by many people whose connexin 26 mutation has led to impaired hearing.

Embryonic hearing?

Inner ear nerve cells facilitate the optimal functioning of cochlear implants. Prof. Avraham's research suggests a possible new strategy for improving implant function, particularly in people whose hearing loss gets progressively worse with time, such as those with profound hearing loss as well as those with the connexin gene mutation. Combining gene therapy with the implant could help to protect vital nerve cells, thus preserving and improving the performance of the implant.

More research remains. "Safety is the main question. And what about timing? Although over 80 percent of human and mouse genes are similar, which makes mice the perfect lab model for human hearing, there's still a big difference. Humans start hearing as embryos, but mice don't start to hear until two weeks after birth. So we wondered, do we need to start the corrective process in utero, in infants, or later in life?" said Prof. Avraham.

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From mouse ears to human's? Gene therapy to address progressive hearing loss

Gene implicated in progression and relapse of deadly breast cancer finding points to potential Achilles' heel in …

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PUBLIC RELEASE DATE:

24-Mar-2014

Contact: Jen Gundersen jeg2034@med.cornell.edu 646-317-7402 Weill Cornell Medical College

NEW YORK (March 24, 2014) Scientists from Weill Cornell Medical College and Houston Methodist have found that a gene previously unassociated with breast cancer plays a pivotal role in the growth and progression of the triple negative form of the disease, a particularly deadly strain that often has few treatment options. Their research, published in this week's Nature, suggests that targeting the gene may be a new approach to treating the disease.

About 42,000 new cases of triple negative breast cancer (TNBC) are diagnosed in the United States each year, about 20 percent of all breast cancer diagnoses. Patients typically relapse within one to three years of being treated.

Senior author Dr. Laurie H. Glimcher, the Stephen and Suzanne Weiss Dean of Weill Cornell Medical College, wanted to know whether the gene already understood from her prior work to be a critical regulator of immune and metabolic functions was important to cancer's ability to adapt and thrive in the oxygen- and nutrient-deprived environments inside of tumors. Using cells taken from patients' tumors and transplanted into mice, Dr. Glimcher's team found that the gene, XBP1, is especially active in triple negative breast cancer, particularly in the progression of malignant cells and their resurgence after treatment.

"Patients with the triple negative form of breast cancer are those who most desperately need new approaches to treat their disease," said Dr. Glimcher, who is also a professor of medicine at Weill Cornell. "This pathway was activated in about two-thirds of patients with this type of breast cancer. Now that we better understand how this gene helps tumors proliferate and then return after a patient's initial treatment, we believe we can develop more effective therapies to shrink their growth and delay relapse."

The group, which included investigators from nine institutions, examined several types of breast cancer cell lines. They found that XBP1 was particularly active in basal-like breast cancer cells cultivated in the lab and in triple negative breast cancer cells from patients. When they suppressed the activity of the gene in laboratory cell cultures and animal models, however, the researchers were able to dramatically reduce the size of tumors and the likelihood of relapse, especially when these approaches were used in conjunction with the chemotherapy drugs doxorubicin or paclitexel. The finding suggests that XBP1 controls behaviors associated with tumor-initiating cells that have been implicated as the originators of tumors in a number of cancers, including that of the breast, supporting the hypothesis that combination therapy could be an effective treatment for triple negative breast cancer.

The scientists also found that interactions between XBP1 and another transcriptional regulator, HIF1-alpha, spurs the cancer-driving proteins. Silencing XBP1 in the TNBC cell lines reduced the tumor cells' growth and other behaviors typical of metastasis.

"This starts to demonstrate how cancer cells co-opt the endoplasmic reticulum stress response pathway to allow tumors to grow and survive when they are deprived of nutrients and oxygen," said lead author Dr. Xi Chen, a postdoctoral associate at Weill Cornell, referring to the process by which healthy cells maintain their function. "It shows the interaction between two critical pathways to make the cells better able to deal with a hostile microenvironment, and in that way offers new strategies to target triple negative breast cancer."

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From mouse ears to man's?

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PUBLIC RELEASE DATE:

24-Mar-2014

Contact: George Hunka ghunka@aftau.org 212-742-9070 American Friends of Tel Aviv University

One in a thousand children in the United States is deaf, and one in three adults will experience significant hearing loss after the age of 65. Whether the result of genetic or environmental factors, hearing loss costs billions of dollars in healthcare expenses every year, making the search for a cure critical.

Now a team of researchers led by Karen B. Avraham of the Department of Human Molecular Genetics and Biochemistry at Tel Aviv University's Sackler Faculty of Medicine and Yehoash Raphael of the Department of OtolaryngologyHead and Neck Surgery at University of Michigan's Kresge Hearing Research Institute have discovered that using DNA as a drug commonly called gene therapy in laboratory mice may protect the inner ear nerve cells of humans suffering from certain types of progressive hearing loss.

In the study recently published in the journal Hearing Research, doctoral student Shaked Shivatzki created a mouse population possessing the gene that produces the most prevalent form of hearing loss in humans: the mutated connexin 26 gene. Some 30 percent of American children born deaf have this form of the gene. Because of its prevalence and the inexpensive tests available to identify it, there is a great desire to find a cure or therapy to treat it.

"Regenerating" neurons

Prof. Avraham's team set out to prove that gene therapy could be used to preserve the inner ear nerve cells of the mice. Mice with the mutated connexin 26 gene exhibit deterioration of the nerve cells that send a sound signal to the brain. The researchers found that a protein growth factor used to protect and maintain neurons, otherwise known as brain-derived neurotrophic factor (BDNF), could be used to block this degeneration. They then engineered a virus that could be tolerated by the body without causing disease, and inserted the growth factor into the virus. Finally, they surgically injected the virus into the ears of the mice. This factor was able to "rescue" the neurons in the inner ear by blocking their degeneration.

"A wide spectrum of people are affected by hearing loss, and the way each person deals with it is highly variable," said Prof. Avraham. "That said, there is an almost unanimous interest in finding the genes responsible for hearing loss. We tried to figure out why the mouse was losing cells that enable it to hear. Why did it lose its hearing? The collaborative work allowed us to provide gene therapy to reverse the loss of nerve cells in the ears of these deaf mice."

Although this approach is short of improving hearing in these mice, it has important implications for the enhancement of sound perception with a cochlear implant, used by many people whose connexin 26 mutation has led to impaired hearing.

See the article here:

From mouse ears to man's?

The future is coming faster than ever, futurist tells Economic Club of Grand Rapids

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GRAND RAPIDS, MI Futurist James Canton was being more than a proud grandfather when he showed the Economic Club of Grand Rapids a photo of a toddler holding a smartphone to his ear.

This is your new customer, Canton told the gathering at the Imperial Ballroom at the J.W. Marriott Hotel at a luncheon meeting on Monday, March 24. He cant read, but he can talk.

The future is coming faster than ever for most businesses, said Canton, the CEO and chairman of the Institute for Global Futures.

And that trend wont slow down or even catch its breath as the worlds population continues to grow and live longer, technology continues to become cheaper and innovators are rewarded, Canton said.

What the Baby Boomers are going to spend a dollar on, the Millennials are going to spend a dime, Canton said, pointing to the falling costs of long-distance telephone calls.

Whos shaping your future? Are you? Canton asked. If you dont have a future ready plan three or four years out, someone else is shaping your future.

To become future ready, Canton said companies need to be focused on their customers behavior and innovators in other industries. If youre in banking, talk to someone in healthcare. If youre in healthcare, talk to someone in video games.

Canton, a former executive with Apple Computer and an advisor to three White House administrations, also has advised more than 100 companies. The Economist recently recognized him as one of the worlds leading futurists.

He also is a frequent guest commentator on CNN, CNBC, Fox, PBS, ABC and business publications. He was named the Digital Guru by CNN and Dr. Future by Yahoo.

Jim Harger covers business for MLive/Grand Rapids Press. Email him at jharger@mlive.com or follow him on Twitter or Facebook or Google+.

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The future is coming faster than ever, futurist tells Economic Club of Grand Rapids

Michelle Obama’s Peking University Speech: Portion Regarding Freedom Blocked By Chinese Authorities – Video

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Michelle Obama #39;s Peking University Speech: Portion Regarding Freedom Blocked By Chinese Authorities
Follow us on TWITTER: http://twitter.com/cnforbiddennews Like us on FACEBOOK: http://www.facebook.com/chinaforbiddennews On March 22 Michelle Obama, wife of ...

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Michelle Obama's Peking University Speech: Portion Regarding Freedom Blocked By Chinese Authorities - Video