Medicare program; appeals of CMS or CMS contractor determinations when a provider or supplier fails to meet the requirements for Medicare billing privileges. Final rule

This final rule implements a number of regulatory provisions that are applicable to all providers and suppliers, including durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. This final rule establishes appeals processes for all providers and suppliers whose enrollment, reenrollment or revalidation application for Medicare billing privileges is denied and whose Medicare billing privileges are revoked. It also establishes timeframes for deciding enrollment appeals by an Administrative Law Judge (ALJ) within the Department of Health and Human Services (DHHS) or the Departmental Appeals Board (DAB), or Board, within the DHHS; and processing timeframes for CMS' Medicare fee-for-service (FFS) contractors. In addition, this final rule allows Medicare FFS contractors to revoke Medicare billing privileges when a provider or supplier submits a claim or claims for services that could not have been furnished to a beneficiary. This final rule also specifies that a Medicare contractor may establish a Medicare enrollment bar for any provider or supplier whose billing privileges have been revoked. Lastly, the final rule requires that all providers and suppliers receive Medicare payments by electronic funds transfer (EFT) if the provider or supplier, is submitting an initial enrollment application to Medicare, changing their enrollment information, revalidating or re-enrolling in the Medicare program.     

Increasing pressure does not benefit lie detection: a reply to Ten Brinke et al. (2015)

When passively attending to suspects, observers are poor at distinguishing lies from truths. Deception research has therefore shifted to examining interview styles aimed at eliciting and enhancing deception cues. Based upon a literature review and three empirical studies, ten Brinke, L., Khambatta, P., and Carney, D. R. [2015. Physically scarce (vs. enriched) environments decrease the ability to successfully tell lies. Journal of Experimental Psychology: General, 144, 982–992. doi:10.1037/xge0000103] recommend increasing pressure on interviewees as it would increase lie detection accuracy. In this comment, we argue that these authors (1) misinterpret the literature when concluding that lie detection benefits from increasing pressure on interviewees, and (2) their data do not show that lie detection is more accurate when pressure is increased. In absence of such data, we recommend that increasing pressure on interviewees should be avoided: it hampers the elicitation of valuable information and can lead to false confessions.     

Analytical review on the major issues of the new bankruptcy (law) legislation

The bankruptcy law is an integral part of the legal system of societies with market economy. After many years of preparation, the draft of the new bankruptcy law in China was submitted to the Standing Committee of the National People’s Congress twice and is waiting for the third approval to be enacted. Drawing on the experiences of other countries, the new bankruptcy law tries to carry out the concepts of market economy, eliminate the residual influences of planned economy that existed in the old law, protect lawful rights and interests of creditors and debtors, and maintain the order of socialist market economy. This thesis analyzes and researches on the major and controversial issues that emerged during the legislation of the new bankruptcy law from the aspects such as the principle of the legislation, criteria of bankruptcy, preservation or abolishment of policy-related bankruptcy, protection of the employees’ rights and interests of bankrupt enterprises, the creditors’ committee system, the trustee system, reorganization system to prevent bankruptcy, and the legal obligations of bankrupt, and so on. It also gives a comprehensive introduction to the innovation and modification of the new bankruptcy law.     

Medicare program; changes to maintenance of effort requirements (section 421 of the Medicare Catastrophic Coverage Act)--HCFA. Notice

This notice announces the effect on employers of the repeal of section 421 (Maintenance of Effort Provision) of the Medicare Catastrophic Coverage Act of 1988 (MCCA). The enactment of Public Law 101-234 (Medicare Catastrophic Coverage Repeal Act of 1989) on December 13, 1989 repealed many of the provisions of MCCA and restored the Medicare benefit levels to those available prior to January 1, 1989. Consequently, employers are relieved of their Maintenance of Effort responsibilities effective January 1, 1990.     

Information does not affect the validity of a comparison question test

Purpose . Detailed information about the comparison question test (CQT) and possible countermeasures are now available on the Internet. This study examined whether the provision of such information would affect the validity of the Test for Espionage and Sabotage, a directed lie variant of the CQT. Method . Forty participants were divided into four equal groups: guilty, guilty informed, innocent, and innocent informed. During a first appointment, participants either did or did not commit a mock crime: then some were provided with a book containing detailed information on the CQT, including possible countermeasures. After 1 week with the book, all participants were administered a CQT during their second appointment. Following the polygraph, participants responded to a questionnaire that asked them about their behaviour and perceptions during their examination. Results . There were no significant effects of providing information on the validity of the CQT. However, the reported use of countermeasures was associated with a lower probability of truthfulness. Results of the debriefing questionnaire were found to support predictions made by the theory of the CQT. Conclusions . Concerns that readily available information will enable guilty individuals to produce false‐negative errors seem unfounded. Moreover, the results actually indicate that the use of countermeasures was associated with a lower probability of truthfulness, which was exactly the opposite outcome predicted by the CQT critics.     

Medicare program; changes to the electronic prescribing (eRx) incentive program. Final rule

This final rule modifies the electronic prescribing (eRx) quality measure used for certain reporting periods in calendar year (CY) 2011; provides additional significant hardship exemption categories for eligible professionals and group practices to request an exemption during 2011 for the 2012 eRx payment adjustment due to a significant hardship; and extends the deadline for submitting requests for consideration for the two significant hardship exemption categories for the 2012 eRx payment adjustment that were finalized in the CY 2011 Medicare Physician Fee Schedule final rule with comment period.     

Alternative light source (polilight) illumination with digital image analysis does not assist in determining the age of bruises

The age of a bruise may be of interest to forensic investigators. Previous research has demonstrated that an alternative light source may assist in the visualisation of faint or non-visible bruises. This project aimed to determine if an alternative light source could be utilised to assist investigators estimate the age of a bruise. Forty braises, sustained from blunt force trauma, were examined from 30 healthy subjects. The age of the bruises ranged from 2 to 231 h (mean = 74.6, median = 69.0). Alternative light source (polilight) illumination at 415 and 450 nm was used. The black and white photographs obtained were assessed using densitometry. A statistical analysis indicated that there was no correlation between time and the mean densitometry values. The alternative light source used in this study was unable to assist in determining the age of a bruise.     

Like bringing a knife to a gunfight: Why IRC Section 2036 is not the right weapon to combat abusive family limited partnerships

Family Limited Partnerships (“FLPs”), which were once a great estate planning technique, have now become victim to Section 2036 assertions made by the IRS. Over the years, the IRS has struggled to find a means to combat abusive FLPs until the courts began to embrace Section 2036 as a weapon for them to use. Different courts, however, have maintained different rules and have now subjected both abusive and non-abusive FLPs to inclusion of their assets into their gross estates. This has shed light onto the main issue, that is, that Section 2036 is not the appropriate tool to combat abusive FLPs.     

Medicare program; criteria for defining skilled nursing facility under Section 1861(j)(1) of the Social Security Act--Health Care Financing Administration. Notice of HCFA ruling

This notice announces a HCFA ruling that restates HCFA's long-standing interpretation of what constitutes a skilled nursing facility under section 1861(j)(1) of the Social Security Act.     

Medicare program; application of inherent reasonableness to all Medicare Part B services (other than physician services)--HCFA. Interim final rule with comment period

This interim final rule implements section 4316 of the Balanced Budget Act of 1997. It revises the process for establishing a realistic and equitable payment amount for all Medicare Part B services (other than physician services) when the existing payment amounts are inherently unreasonable because they are either grossly excessive or deficient. This rule describes the factors HCFA (or its carrier) will consider and the procedures it will follow in establishing realistic and equitable payment amounts.     

Plans established or maintained pursuant to collective bargaining agreements under section 3(40)(A)--Pension and Welfare Benefits Administration. Notice of intent to form a negotiated rulemaking advisory committee

The Department of Labor (Department) intends to form a Negotiated Rulemaking Advisory Committee (Committee) in accordance with the Negotiated Rulemaking Act of 1990 and the Federal Advisory Committee Act. The Committee will negotiate the development of a proposed rule implementing the Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1001-1461 (ERISA). The purpose of the proposed rule is to establish a process and criteria for a finding by the Secretary of Labor that an agreement is a collective bargaining agreement for purposes of section 3(40) of ERISA. The proposed rule will also provide guidance for determining when an employee benefit plan is established or maintained under or pursuant to such an agreement. Employee benefit plans that are established or maintained for the purpose of providing benefits to the employees of more than one employer are "multiple employer welfare arrangements" under section 3(40) of ERISA, and therefore are subject to certain state regulations, unless they meet one of the exceptions set forth in section 3(40)(A). At issue in this regulation is the exception for plans or arrangements that are established or maintained under one or more agreements which the Secretary finds to be collective bargaining agreements. If adopted, the proposed rule would affect employee welfare benefit plans, their sponsors, participants and beneficiaries, as well as service providers to plans. It may also affect plan fiduciaries, unions, employer organizations, the insurance industry, and state insurance regulators.