Month: January 2016

Background Checks and the 2nd Amendment

amGun control proponents focus on enacting Universal Background Checks as the next step in preventing gun violence. Pro-gun groups dispute the need for more checks and see the concept as advancing a plan to subvert the right to bear arms. They fear government tracing of firearms and seek to deny progress to 2nd Amendment detractors.

Background check advocates claim overwhelming public support, yet four of the last six states to consider the idea for private transfers have rejected it. Washington State approved the checks by voter initiative last November. New Hampshire, New Mexico, Vermont, and Virginia all refused to require the checks since then. Oregon recently enacted a background check law, but similar pending legislation in other states is by no means certain to pass, or even likely to be considered.

Members of the U.S. House of Representatives reintroduced a bill (H.R. 1217) to require background checks for most firearms transfers last January. The proposed law failed in the U.S. Senate during April 2013, as an Amendment to the Senate Gun Control Bill. I expect it to fail again, this time in the Judiciary Committees. Let me explain why this law keeps failing and why the efforts to pass it seem futile.

Universal Background Checks would not have prevented any of the seven major shooting events of the 21st Century, from Virginia Tech in 2007 to Charleston this year. Six of the seven shooters, Cho, Hasan, Loughner, Holmes, Alexis and Roof received approvals from the National Instant Background Check System (NICS) when they acquired their guns. The seventh stole the rifle he used from his mother, after murdering her with another of her guns. She had purchased them from local dealers with NICS checks.

Many firearms involved in other crimes have been through a background check and whether they have or not makes little difference. Criminals simply do not buy their guns legally. The National Institute of Justice says that most guns used in crime come from theft or straw purchases. Since both acquisition methods already break the law, adding the crime of avoiding a required background check has no appreciable deterrent value.

Gun control advocates, like “Everytown For Gun Safety” and “Americans For Responsible Solutions,” appear to lead the effort to enact Universal Background Checks for two reasons beyond the stated purpose of stopping prohibited purchases. These two unstated purposes may not seem futile, if your goal is to reduce or eliminate civilian ownership of most firearms.

First, the computer records created will improve the government’s ability to trace firearms and help enforce other gun control measures. The Obama Administration wants tracing “to prevent anonymous stockpiling of firearms,” according to oral arguments in a U.S. Supreme Court case involving background checks (Abramski v. U.S., No. 12-1493, 2014). Some states with Universal Background Check laws already use the records to confiscate firearms. In New York, the Secure Ammunition and Firearms Enforcement Act lets law enforcement cross reference databases to search for illegally possessed firearms. California does the same with its Armed Prohibited Persons System. The Chicago Anti-Gun Enforcement unit confiscates guns under the city’s Firearms Ownership Identification program.

Second, gun control supporters seek “progress” towards larger goals. For example, the proponents of Washington’s successful initiative recently announced new anti-gun proposals. After the 2013 U.S. Senate Gun Control Bill background check amendment failed, President Obama said: “So while this compromise didn’t contain everything I wanted or everything that the [Sandy Hook] families wanted, it did represent progress.” The progress the President seeks is toward a goal of “transformation” to restrictions like those “in the United Kingdom, in Australia… ,” as he stated after the Navy Yard shooting and again in Charleston.

2nd Amendment defenders understand these two reasons quite well and find them abhorrent, so they fiercely oppose Universal Background Checks. With determination to make progress on one side and political resistance on the other, the futile showdown over background checks continues.

How to Get Managed Care Companies to Pay for Your Practice’s Improvements

hyThe following examples should illustrate why: The CMS Value Based Program with hospitals is already implemented; Center for Medicare and Medicaid Innovation is piloting NUMEROUS programs covering many physician specialties; CMS expanded the Medicare Shared Savings Program to 3 tracks; A new Merit-Based Incentive Payment for Physicians, Physician Assistants, Nurse Practitioners, Clinical Nurse Specialists, and Certified Registered Nurse Anesthetists will be apply to payments for services furnished in 2019.

The train has left the station. Providers will now shift from fee for service to value based payments with CMS. To be successful and still have a profitable business, clinical integration and quality improvements will need to be implemented to improve your practice whether you are hospital based or office based AND whether you are employed by a hospital or in private practice. These changes will be implemented for all of your patients as you will not distinguish in your level of service between patients with managed care as the payor rather than CMS. This essentially means that managed care payors will reap the benefits of these improvements in your practice. If you do not have a value based contract in place with the managed care payors they will not be sharing one dime with you. They will reap the benefits of your improvements AND keep the money! And by the time you get around to a managed care contract that is value based, the shared savings opportunities will be less than if you began those discussions now.

So what are the “improvements” in your practice that will be required for you to be successful in this new payor world? In the previous article titled “Volume is no longer King”, we discussed determining the financial risk that your practice can take on and finalizing the quality metrics that best suits your practice. The next step is Assessments and Implementation Strategies.

Data that is truly informative will be essential. Assessing your baseline for those quality metrics that you have finalized is the first step. The question to ask is what your performance for each quality metric has been for the past 24 months and where it is currently. This is necessary as you want to evaluate your current performance to see if it is a consistent number/evaluation or a blip in the results.

Once a baseline is determined, what can you do to improve that number? Gathering your office staff for their input is a great place to start. In the quality world, we call that going to the Gemba. This means that you go to the front line of your office staff. They have great ideas on how things can be improved. They see these processes in action every day. Take down all suggestions and vet them with a smaller group. Put together an action plan where you identify start and end dates for each item so that you can pilot and measure what works and what doesn’t make an impact on your data. It will likely take several rounds assessing, planning, implementing and evaluating to get your data moving in the right direction.

Ensure this opportunity for success is included in your contracts with managed care payors. By taking the lead, you will have the opportunity to share in your successes and not give away this information for free.

How Do You Prevent Odometer Rollback Deception

uIf you wish to buy an old car it is vital that you should check its condition and you should also examine other relevant things that are related to it. It is vital that you should check if its odometer is in perfect condition or if it is rolled back at any point of time. If a car dealer sells a car whose odometer is broken or whose odometer is rolled back, then it is considered to be an illegal activity. This article will highlight on a few essential tips that you should consider in order to avoid odometer rollback deception to the best of your abilities.

You should request your car dealer to show you the title document of the particular car that you wish to purchase. You have to examine it closely and you have to check if its mileage seems to be obscured or if it is written in an inappropriate manner. Plus, you should check the exact date of issue of its title and you should be apprehensive if this type of vehicle is being sold immediately after it has been issued. Often it is seen that the new title of this type of vehicle is often issued in order to hide this type of incident in the best possible way.

The next step is to compare the exact mileage that is indicated on this type of device along with that indicated on the maintenance record of that particular car. Moreover, you should find out if the mileage that is written on the maintenance sticker on its door or in any other parts should be consistent with the one that is shown on this type of device.

You should also find out if all the numbers of this type of device are aligned in a proper way. It is vital that they should not get twisted or they should have gaps in between them whenever you hit on its dashboard with your own hand. If it has an analogue odometer, then it is vital that all the numbers remain in straight lines.

It is vital to remember that the digital odometer that is often used in this type of vehicle can only display numbers in the best possible way. However, if the particular car has this type of odometer and if it displays a symbol or any other sign, there is possibility that this device has been rolled back at some point of time.

You should find out the possible signs of wear and tear on mat, pedals for brake and other probable areas inside this kind of vehicle. If you find out that any of these items is replaced in recent times it is advisable that you should be alert and you should consider it as an example of odometer rollback fraud.

You should also check out the manual of the car dealer if the maintenance of this type of vehicle was listed or if the pages of this type of manual that might have shown high mileage were removed at some point of time.

If you think that this type of device has been rolled back at some point of time, then you should hire an experienced mechanic to check emission system, engine, suspension as well as the steering system for an excessive amount of damage. An expert mechanic should be able to tell if this type of device has been tampered or if it is broken at some point of time.

Things to Be Remembered While You Defend a Credit Card Debt Case

tIf you do not pay your credit card bill at all or if you do not pay it within the deadline, there is possibility that the credit card company may file a lawsuit against you. If your credit card company sues you, there is possibility that it may serve you with a court summon and if you get this kind of summon, it is advisable that you should send your reply as soon as possible. This article will highlight on a few essential tips that you should follow to defend this type of lawsuit in the best possible way.

The first step that you should follow is to find out the exact time limit that has been set up for your credit card company to file this type of lawsuit and you should also check if it at all has fulfilled this type of requirement. If you find out that it has crossed the time limit that has been set up by the state in order to file a lawsuit, it is advisable that you should use it as your defense against this type of case.

You should ask for verification of debt from this type of company without any kind of delay. It is vital to remember that it needs to confirm that you really owe money on it. In order to verify it, it is advisable that it should check your Social Security Number and other personal details such as your name, address and telephone number, etc. If it fails to give the necessary information for debt verification or if it is found that you do not owe any money to it, then it is advisable that you should immediately inform it to the judge.

Once you have received the court summon, it is important that you should prepare your reply and you should submit it to your court as soon as possible. If you do not submit your reply right on time, there is possibility that your credit card company will win your case by default. All you need to do is to deny all sorts of allegations and to raise all kinds of defenses that you are able to use to defend this type of case. You can use different types of defenses such as calculation of payment in an incorrect way, filing of lawsuit outside the statute of the limitations and so on.

The next step is to collect the bank records, canceled checks, bills and other essential documents as quickly as possible. All you have to do is to make copies of these documents as well as organize them properly whenever you present them to the court. It is vital to remember that since your credit card company has filed this lawsuit in the court it is its responsibility to prove that you actually owe a debt to it.

It is important to remember that you should not fail to appear on the court on the day of trial. If you fail to appear in this type of session, there is possibility that this type of company may win the case by all possible means. All you have to do is to show your evidence to your judge and to request him to examine the witnesses in the best possible way. On your part, it is vital that you should be able to defend yourself as much as you can.