. >> the commercial r x plan for the early retirees not a cms regulated plan in place today i believe we have a little bit under one hundred people as the plan that does not have ab so those folks will not be able to enroll in a medicare advantaged plan because cms required ab city enrolled. >> if you look at the plans first, i want to talk about the medical the medical benefits quoted under the ppo it current to the network plan on average the members as a whole pay a similar amount under the proposed arrangement some costs are more and some less i'll get the chart. >> i'm saying as i read through the proposal i participated on the call with director dodd and it seems like everything was we can do it all and whether that carries through is understanding the level of detail so when i see a sweeping statement matt haney members of a whole paying a average i get nervous i want to see a memoranda price because averages range from god awful million dollars dollars to a few cents in change it would be helpful when you're making those references to have the data to support it but talk about

is cms intervention. >> we're no longer working with them. >> that's incorrect so your working with intervention security group and they are licensed by the state of california and guard carted. >> that's correct. >> and trained. >> that's correct. all that is from the police department. >> that's great has this security company is the one you've been working with on is temporary. >> cms of i up to new years eve and we termed their contract and brought only interference. >> your pleased with interference. >> yes. there's been a bunch of incidents i wanted to during your operations and so i have to ask you what experience do you have in running a bar. >> i managed kokomo for seven years i'll i'm not bringing that on as my burgundy experience and good. >> one thing it is not correlate to the operations at fort one at all it was basically keeping in you know hiring people. >> okay. on february 14, 2015 there was an assault in front of your club 3 people were denied industry and attacked the doorman do you have a occupancy rate of 398 and put guards in at 3 hundred you have 3 doors and

improperly made, basic policy is that cms and hhs. a responsible when the payments are made on the basis of improper identification. collecting it again is up to them. senator lankford: up to hhs? because there are 300,000 people that do not have citizenship this point. that is over there? mr. koskinen: yes. senator lankford the law prohibits employers from reimbursing or providing financial employers -- sorry, to employees -- to help them pay for and individually purchased plan. so someone says they are going to go on the general market. the employer will provide them some sort of amount. in the past, small businesses would say, i cannot afford a policy. but i will find a way to help you do that. my understanding is that not -- is not legal anymore. are you aware what the tax policy is? mr. koskinen: it is my understanding that is a tax policy. that is a policy set by the treasury department in response to statutory language. senator lankford: does the irs carry out the penalty part of the? mr. koskinen: once someone has decided what

and cms is committed to having that 50% by 2018. it's now at 30. it's going to go to 40 and it will be at 50. that is an enormous change in the way financial incentives can align with outcomes. and will make a huge difference to everybody. >> leader, you're now in the private sector and venture capital. what is the most exciting thing you're seeing out there when you look to the future what's happening with efficiencies and improved outcomes as a result of the things the secretary just mentioned? >> right now i'm vice chairman of mull ifrmtss and company, an investment bank. we have a fairly robust health care practice and what we are seeing is, there's a lot of increased focus of attention on a lot of providers. you're seeing a lot of private equity interest in coming in to the space. you are also seeing big players looking at -- and there's a lot of press reports about big acquisitions and mergers and consolidations. and i think that's a direct result of what the secretary referred to about the move toward quality based payment systems. in other

there are 30 or 40,000 of those who are being worked through by cms. senator johnson: you did correctly state that what they are paying, $11,550 is not a penalty, it is a reimburse ofment the subsidy that they are incorrectly provided. they view that as a penalty. and you can understand that. they followed all the rules. i was reading what they said. i take your point. but speaking of penalties, that is one of the things i found interesting in the briefing packet. the average penalty paid -- is -- those who decided to exercise their freedom and not purchase insurance. is that a penalty or a tax? the $95 is that a penalty or tax? commissioner koskinen: it is called the shared responsibility payment. senator johnson: the average shared responsibility tax is not the $95 minimum, it's the $1% of income that is about $172 is that correct? commissioner koskinen: 95 is the minimum but it goes to 1% of your income. it is $95 for adults and your family. senator johnson: if you extrapolate, that is 80% higher than the minimum. 172 is 1.8 times the minimum of 195

. >> on this point i say you say you haven't filled the cms your formula for 2006 when will- >> that will be foiled over the summer. >> that would be important this is a business prospective you've got to get an approved by certain dates i'd put a red star besides that one i don't know how long is take for powerful they motive fast tracking track you through the process but knowing again, we're kind of doing this without kind of the full detail is from a policy standpoint raises a question. >> of we'll get more information on that, too. >> can i ask the mechanic formula is the same as the other. >> it would be the same formula last year, it is the treatment of high-risk medication. >> but an approval process with the cms. >> surely we do that every year. >> okay. all right. >> do you want to mention that their expected to be rolled out to your part d plan we're starting in 2016 with the medicare advantage plan last sliced we're talking about the advantages of the national p p pox your members are flexibility they can go to in network and out of network doctors and enjoy the same plan

those forms are provided and designed and filled out by cms. they would be the ones if anybody knows they would know. >> and do you think that the people who waited a little longer, as i understand they're being treated differently and still on the hook for paying that if they owe a larger premium that they, as i understand, there may be a distinction between those depending when they filed and how they're treated how are the people in the country that were misled, in terms of what they thought they were going to be receiving, not receive, having to pay, how are you going to treat the individuals? what are we going to do with the lost revenue? zblf the 800,000, the estimate was 50,000 filed 750,000 were in the same pool. and the 50,000 could file amendment if they wanted to. so it's not a distinction. terms of being misled, we've had a long -- i think informative discussion, that -- i think after the transition of the first year people will understand it better when you register and apply for a insurance coverage, you make an estimate of what y

i believe she did call the irs initially but redirected. >> probably referred to the cms. >> yes. anyway, lots of questions about how we can help solve this problem and really the scope of the problem. if you could today give us what the irs' best estimate is of the best percentage of people who received a subsidy in 2014 and have to repay a portion of that subsidy, do you have a sense of that? >> we won't know because it takes us a while to post and there will be another three or four weeks. thus far, it appears that sluthly less than half of the people are getting an increased refund because they got smaller advance payment of the premium tax credit than they were entitled to. and that's because based on their final income. about 50% to 55% are getting a smaller refund because they got too much advance payment beyond but still getting a refund but it is an adjustment and the adjustments are -- we don't know what the dollars are. i've seen tax preparers estimate their experience is showing $300 one way, $500 another way. we don't have information indication of who actually as a r

and cms is committed to having a 50% by 2018. it's now at 30. and good affordability at 50. that is an enormous change in the way financial incentives in line with outcomes. and will make a huge difference to everybody. >> leader, you and the private sector around venture capital. using investments being made by businesses and health care space. what's the most exciting thing you're saying out there when you look to the future? was happening with deficiencies and improved outcomes as a result of the things the secretary just imagine? >> right now i'm vice chairman of the company, an investment bank. we have a fairly robust health care practice and what we are seeing is there's a lot of increased focus of attention on a lot of providers. you were seeing a lot of private equity interest coming into the space. you are also seeing big players looking at and there's a lot of press reports about big acquisitions and mergers and consolidation. and i think that's a direct result of what the secretary referred to about the move toward quality-based payment systems. in -- in other wor

nih, fda cms just to name the big three. they have a tremendous impact on our economy.the jobs they provide and the jobs they stimulate. we could not have the robust biotech community we have in maryland without you. we will of course be talking about those issues but i'm going to goods right in the maryland maryland -- right to a maryland issue. my mounting counties in appalachia. either situation where due to the census they are telling me that allegheny county right next to our colleagues in west virginia has lost their designation for federal funding to qualified for the affordable care. i wrote you a letter in february february. your staff has been calling back and forth but we have been told recently there is nothing you can do. madam secretary ned to look into this. you know western maryland. you know those mountain counties. you know they have lost population. you know that they have lost jobs. we don't want them to lose hope in their government. the impact is $2 million. that might not be allowed by our spending up here but that enable them to attract doctors.

there have been adjustments made by cms which runs the marketplace. even there the estimated 4.5 million taxpayers will file [inaudible] it is a relatively smaller percentage. senator carper: gene [inaudible] was here yesterday and spoke pretty much without notes and did a terrific job. one of the questions i asked him was, what can we do to help the irs serve the people of this country, make sure that we are meeting our responsibilities as taxpayers and making sure we are providing the kind of service we would expect, hopefully the kind of service when claire mccaskill was auditor and i was treasurer we provided really good service. the state of delaware one the -- won the quality award. it galls the hell out of me to know that people call the iris and they have to wait forever to get someone on the line. they have to wait to go see someone. we are complicit in that because we are not providing a reasonable amount of funding for the irs. yesterday, gene said there are things the irs has done to use the resources more efficiently and there are some th

our best in order to communicate and attract bidders for it, we have four prequalified bidders and cm/gc is engaged with them, so we're hoping to get a healthy pool of bidders and we're trying our best for that. >> and the scope for that is the whole park? >> the scope for that would be the landscaping, the hard escaping for the park, the electrical and the mechanical elements nr the park are being negotiated with the current bidders to see if we can get a fair and reasonable price with them as a change order, if that doesn't happen, we will bid them out separately. the entire scope of the park is being negotiated either with existing bidders or the landscape contract has been advertised. >> so, i understand -- i thought that you had taken those elements out of those existing mep contracts deliberately? >> yes. >> so, now after taking them out, now you're negotiating with the winning bidders to see what kind of price they would give? it's less likely to get us a competitive price? >> if we don't get a fair and reasonable price, we will bid them out separately. because of the budgetary

demonstrates we were able to meaningful use the electronic health records those measures were developed by cms and came with financial sensitive for networks that can show we're meeting criteria regarding the use of hr and the portal in the design phase of this our task was to think of a way to take all our systems as dr. chin talked about and combine them into a comprehensive portal i'll talk about that latter in the presentation apart from that in particular just to provide a improved care experience for our patient in the network that is a website in which patient over and over their clegd proxies look at the electronic health record and provide access to a patient education database to search tops this is not be attorney general offer high-level things like e-mail or appointment requests we hope to integrate that into the future next slide speaks to the some of the challenges about trying to consecutive a permanently all the patient receive in the network in the end we face many challenges maine to inoperable ability we heard fragment of italy's systems trying to create one portal for the

tatuaje, que es la marca de pÓlvora que queda en la piel, cuando los disparos se hacen a menos de 20 cmo de mis fuentes, yo le quiero decir que las declaraciones que me hicieron a mi consta en la declaraciÓn ministerial de ellos, que dieron los 44 detenidos, y que 13 de ellos, yo los entrevistÉ y sus nombres estÁn en esas actas y en la boleta de liberaciÓn, yo no voy a revelar el nombre de mis fuentes. >> quisiera aprontarte que tan peligroso fue para ti hacer este mitigaciÓn que contradice la versiÓn oficial de los hechos? >> fue muy peligroso y lo que yo pido es que se haga una investigaciÓn para que se investigue la cadena de responsabilidades a nivel municipal, estatal y federal. >> estoy siendo acompaÑada y protegidas por una organizaciÓn de protecciÓn a periodistas. >> gracias por estar .. ... . >> las Últimas encuentas quÉ hice seria una evidencia. >> dentro de mi punto de vista es preocupante. } >> me parece que hillary cuenta con un gran apoyo de la comunidad hispana. >> ella deberÍa estar en este momento en el 80 y 90%. >> si las elecciones fueran hoy, por quiÉn votarÍan pregu

cms or hhs had $800 million, and the 1st dr. was hired in the middle of summer with when they requested a bump up in anticipation of a surge of unaccompanied children. just make that. and follow-up. nonetheless you mentioned it. it just popped up and has bugged me ever since. she was a dedicated physician but had been hired as the 1st. there have been two or three nurses but never a physician no offense against the nurses. they were just a few of them secondly, you mentioned the effects. i want to speak for that physician in small practices. and small practices. the big hospital chains are ready, but what i am reading here cms estimates that in the early stages of implementation rates will rise and the days and accounts receivable we will grow from 20 to 40 percent. it goes on to explain why. i will just say, according to your own website that urologist in south louisiana , one or two person practice she cannot afford to have denial go from 100 to 200 percent and her ar going by 20 to 40 percent. personally, i think the reasonab

you said to b(cm we know. we understand.urvivors andçóxd heroes of the oklahoma city bombing.t(xd bombert( timothy mcveigh was executed in 2001 and his accomplice terryok nichols sentend' plefá are found dead inside a 0ylvania motel room. what customers heard and whaíi police are saying happened xd inside. >>> and honoring a fallenjf friend. why this lacrosse tournament more about winning today. that's still ahead. wow something sounds sweet in here!!!! ♪ ♪ need a little honey in the bowl. yeah!!! badabopbopbopa!!! no? must be the honey!!! >>> a massive bush fiue if california burnled more than 300 acres solp far forcing people and animals out of their homes. they had to build shelters for people and horses. many of thexd animals had to be led to safety afterçó the flames spread. firefighters say thep0iave about 15% of that fire contained. the fire is threatening about 200 homes. >>> investigator[ rre t÷9 of three people found in a sen pennsylvania motel room this morning and police say one ofzv them killed the other two bef

has a homegrown survey they've met their target primary care additional speciality care use another cms tool they met their target this one has expand if 236 clinics and expand to the speciality clinics and san francisco board of appeals uses another tool and the whole task force is working on the task scores number 9 our clinical measure we're proud of achieving 70 percent mammogram rate comparable to commercially insured patient and the last measure is around care coordination the primary care coordination and while the methodology changed over the baseline they've met their target i realize it's a rolling overview you have a lot of documents i'm happy to answer any questions or clarify any part of this i want to talk about quality measures and answer questions altogether >> right? >> okay. >> when we talk about health care measurement but talk about 3 big budget operational and financial and clinical i mean experience when you think of a way forward metric we say one financial and one clinical that doesn't mean we're not tracking a mri idea of measures scott wiener we have so many th

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cm louis, hotel and restaurant workers union 2. i appreciate and you are quite right to ask the tough questions about a sole-source. you are going to hear in public comment the reasons that this project is quite exceptional. i just want to put this from our perspective: what is most critical here? as you know for almost two decades, the city has required to developers on their lands to protect the fiduciary interest of the city through labor piece agreements. this project goes way above and beyond this. the developer approached our union with the intent and idea of negotiating an agreement that guaranteed good quality jobss and not just this project, but every project that they develop nationwide going forward. and from our perspective, that really drives home the level of commitment that they have to making this project exactly the kind of project that the port needs more of. the kind of project that brings not just jobs, but good-quality, living-wage jobs, to portlands, which have traditionally been the center of good quality liv

el gobierno de chile decretÓ una alerta sanitaria debido a la caÍda de 30 y 40 cm de cenizas.umarola de 15 km de altura se apreciaban fuertes tormentas elÉctricas. ahora se estÁ formando otra tormenta alimentada por el descontento de los habitantes de la zona. >> un vecino se le derrumbÓ la casa, no lo dejan pasar. >> queremos limpiar y no nos dejan pasar. periodista: los campos de cultivo quedaron enterrados bajo la ceniza que tambiÉn amenaza la vida del ganado y las mascotas. >> tenemos animales encerrados, por favor. cÓmo va a ser tan inhumano? yo quiero que la gente protectora de animales estÉ aquÍ. periodista: afortunadamente no hay vÍctimas humanas. a un hombre que figuraba desaparecido lo encontraron en una zona boscosa. marÍa: es uno de los tres mÁs peligrosos de los 90 volcanes activos que tiene chile. leÓn: en mÉxico explora la posibilidad de otorgar permisos a extranjeros para que porten armas en territorio mexicano. asÍ lo avalÓ al pleno de la cÁmara de diputados. reformarÍa la ley de armas de fuego y explosivos, este dictamen se deriva de una iniciativa del presid

cms recently came out and said that we want quality based payments, bundled payments. those are the kind of things that i think everyone is for. the recently passed fix went in that direction. >> a rare but hopeful example of a bipartisan deal, they did a fix that fixed the medicare rates and they changed the way that health care is provided in a meaningful way in terms of reimbursements. kathleen sebelius the sdr is about dr. paydoctor pay. the senate has not passed it. we hope that they will pass it when a they come back. it contains a lot of elements that comes directly out of the affordable care act. they moved to a value-based payment, picking up accelerated issues that cms has put on the table. this is the framework the law jumpstarted in 2010. it has very much been under way. there are a lot of people -- a lot of the attention, 90% of the attention of the press, has been around the marketplace or medicare expansion. and that is the slice of the market. it is like watching synchronized swimming and only paying attention to the bathing caps. there is a lot of thin

what caused and led up to the accident.Ñi >>> tod#ay funeral services will be held inrcamden for erica cme wast(fát( missing for more than two months before shefá was found murdered. crippen was 26 years old.çó she disappeared on new year's eve. last month her body was found tied up and covered in duct tape in a wooded area of maryland.Ñiq investigators say her husbandçó killed her and his mother helped cover up the murder.lpsn g the beef and beerfá event at st. dominick's on frankford avenue in holmesburg.Ñi strange was a navy s.e.a.l. that died in a crash in afghanistan. >>>Ñi a source said investigators were lookingt( forok e-mails when a >>> a montgomery countyñr judge orderemrakne to appear ini] court on april 27th. judge william carpenter wants kane to explain why her office fired a top prosecutor who was also an investigator in a grand jury investigation.okt( kane's office says the firingçó was part of restructureing. kane's attorney says i can assure judge carpenter that the last two years, appropriate management decisions. her chief of staff resig/li last week after only four mo

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cm louis, hotel and restaurant workers union 2. i appreciate and you are quite right to ask the tough questions about a sole-source. you are going to hear in public comment the reasons that this project is quite exceptional. i just want to put this from our perspective: what is most critical here? as you know for almost two decades, the city has required to developers on their lands to protect the fiduciary interest of the city through labor piece agreements.

tealso lose noel who leav teamin t fourth wi a srned right ale as he cm down under the baet och landg on aoer pyer. h wain the walki boot a hi, anne. how are you doing? hi, evelyn. i know it's been a difficult time since your mom passed away. yeah. i miss her a lot but i'm okay. wow. that was fast. this is the check i've been waiting for. mom had a guaranteed acceptance life insurance policy through the colonial penn program, and this will really help with the cost of her final expenses. they have been so helpful and supportive during this time. maybe i should give them a call. i really could use some more life insurance. is it affordable? it costs less than 35 cents a day-- that's pretty affordable, huh? less than 35 cents a day? that's less than the cost of a postage stamp. so, you said it was guaranteed acceptance? yes. it's permanent coverage with guaranteed acceptance for people ages 50 to 85. there's no medical exam or health questions. you can't be turned down because of your health. it fit right into mom's budget and gave her added peace of mind. you should give them a call i

next hear from the famous hosts on how they plan to deal with 81 of this year's biggest challenges at cmwa >>> push is on tonight to strengthen security at the white house. steal spikes will soon be installed a top the white house fence in an effort to discourage any potential fence jumpers. those spikes will measure half an inch and be placed at a 5-degree angle. they're have been three white house security breaches just since september. former homeland security secretary and former pa governor tom ridge says they often lead to important lessons. >> we shall not have a failure of imagination. so there was a breach on the congressional lawn. there's a breach at the white house. don't think that our enemies may use these old proto kohl's, old approaches they may took a look at those lessons learned and apply them themselves. >> install laying of those spikes could come as soon as next summer. once they're approved by the national capital planning commission. >>> millions of honey bees swarm a highway near seattle after a truck overturns there. the truck dumped 448 hives that's about 14 mi