IRS inflation and cost of living adjustments impacting you

2009 Inflation-adjusted Amounts: To keep pace with inflation, the IRS modified dozens of tax benefits for 2009. For example, the (1) value of each personal and dependency exemption for most taxpayers will be $3,650 (up $150 from 2008); (2) standard deduction will be $11,400 for married couples filing a joint return (up $500), $5,700 for singles and married individuals filing separately (up $250) and $8,350 for heads of household (up $350); (3) tax-bracket thresholds will increase for each filing status; (4) Section 179 limit will be $133,000; and (5) annual gift exclusion will be $13,000. Rev. Proc. 2008-66, 2008-45 IRB .

2009 Pension Plan Amounts: The IRS published cost-of-living adjustments to various pension plan and related amounts for 2009. For instance, the (1) benefit limit for defined benefit plans will increase from $185,000 to $195,000; (2) defined contribution plan limit will go up from $46,000 to $49,000; (3) compensation limit for determining benefits and contributions will increase from $230,000 to $245,000; (4) definition of a highly compensated employee will go from $105,000 to $110,000; (5) elective deferral limit will go from $15,500 to $16,500; (6) SEP contribution threshold will increase from $500 to $550; and (7) SIMPLE retirement account limit will increase from $10,500 to $11,500. News Release IR-2008-118 .

2009 Social Security Wage Base: The social security wage base will increase from $102,000 in 2008 to $106,800 in 2009. As in prior years, there is no limit to the wages subject to the Medicare tax, so all covered wages are subject to the 1.45% tax. The FICA tax rate, which is the combined social security tax rate of 6.2% and the Medicare tax rate of 1.45%, remains at 7.65%, while the self-employment tax rate remains at 15.3%. The threshold for coverage for domestic employees will be $1,700 in 2009.

30 tips for getting along with others - it's important in the physician's office

1. Follow Dale Carnegie’s advice: “Remember that a person’s name is to that person the sweetest and most important sound in any language.” Pay attention when someone tells you their name, remember it, and use it often when talking to them.

2. Take a genuine interest in other people. Find out what’s important to them, what their aspirations are, and what makes them tick.

3. Be generous. Think of ways in which you can help others.

4. Follow up. When you meet someone don’t just get their business card or e-mail address and then forget about it. Find a way to stay in touch.

5. Look others in the eye when you speak to them.

6. Provide value.

7. Be authentic. Let others see the real you.

8. Make others feel important and appreciated.

9. Offer sincere compliments.

10. Follow Stephen Covey’s advice: seek first to understand, and then to be understood.

11. Mirror them. You can do it consciously to help build rapport by copying a number of aspects such as their basic posture, the position of their arms and legs, and the placement of their hands. Are they sitting forward, legs crossed?  You can also mirror their breathing rates, the rhythm of their movements, and their energy level.  Subtly match two or three things to enter into their world.

12. Smile. A warm, inviting smile will help put others at ease.

13. Display open body language by leaning toward the other person, sitting or standing with an upright posture instead of hunching over, and uncrossing your arms.

14. If someone has done something for you send them a hand written thank you note.

15. Make others laugh. Laughing with others is a bonding experience.

16. First give and then think about getting.

17. Keep the promises and the commitments you’ve made to others.

18. Be punctual. Being habitually late is disrespectful of the time of others.

19. Try to find common experiences or interests. People have a tendency to like others who are like them.

20. When you’re talking to someone give them your undivided attention.

21. Listen actively to what the other person is saying. That is, concentrate on them instead of mentally rehearsing in your head what you’re going to say next.

22. Paraphrase what the other person is saying to make sure that you’ve understood. Say something like the following: “I’m going to repeat in my own words what I think I heard you say to make sure that I’ve understood. Please correct me if you feel that I’ve misunderstood you.”

23. Make a first good impression.  When you first meet someone it takes them about three seconds to form an impression about you, and first impressions are hard to reverse.  They make this evaluation based on your appearance, your body language, your demeanor, your mannerisms, your personal grooming, and how you’re dressed.

24. Project a positive attitude.

25. Don’t whine or complain.

26. Share your interests. Let others get to know you.

27. Pace their volume. Someone who speaks softly will appreciate someone else who speaks softly. Likewise, someone who speaks loudly will often get along better with others who speak in a louder tone.

28. Pace their speech rate. Some people speak quickly and use short pauses between ideas, while others speak slowly and use longer pauses. Try to use the same speech rate they’re using.

29. Acknowledge other people’s field of expertise and ask for their opinion and advice in that area.

30. Albert Mehrabian established that 55 per cent of communication is in the body language, 38 per cent in the quality of the voice, and 7 per cent in the actual words spoken. Make sure that you use all three of these channels in a way that will best get your message across to others.

Get Ready to Relearn the ADA

Get ready to relearn the Americans with Disabilities Act -- by Jan. 1, 2009. New legislation signed last month has defanged a common employer defense, and the changes are going to have real repercussions in the workplace.

On Sept. 25, 2008, with his father looking on, President George W. Bush quietly signed legislation that significantly broadened the scope of protection available under the ADA. The legislation, known as the ADA Amendments Act of 2008 (ADAAA), "carries out the ADA's objectives" to expand coverage by, among other things, expressly rejecting Supreme Court cases that narrowly construed the definition of "disability" under the ADA.

To read more: http://www.law.com/jsp/ihc/PubArticleIHC.jsp?id=1202425609633

 

HIPAA employee training - how often?

Remember that the HIPAA privacy and security rules require you to provide regular HIPAA training for all work force members. But there is no requirement that work force members receive a specified number of hours of training annually. However, HIPAA requires organizations to provide training for new work force members. It also requires periodic refresher training. General work force refresher training doesn’t need to be longer than one-and-one-half to two hours as long as the training covers all the aspects of HIPAA that work force members need to know to adhere to required privacy and security policies, procedures, and practices. Training should also include information about additional HIPAA privacy and security resources or training that might be available.

Collaboration is key to stronger referral relationships

Delayed treatment, dissatisfied patients, and decreased referrals too often result from failure to properly manage the referral process. In an ideal situation, three primary steps take place in coordinating referrals between the primary care provider (PCP) and a specialist. These steps are:

1. The referring physician contacts the specialist and explains the referral reason.
2. The specialist treats the patient and promptly communicates findings back to the PCP.
3. The PCP, specialist, and patient work out ongoing care as needed.

It's important that collaboration occurs between the PCP and specialist in order to ensure the patient receives the best care possible.

Listen to your patients

All of us, including our patients, want to be heard. We value relationships with people who really listen.

And letting patients know that you see them as people goes a long way. For example, a patient would much rather be known as the proud grandmother who grows dahlias than as the 62-year-old female with mild hypertension and arthritis.

Patients also value relationships in which their self-esteem is validated. That doesn’t mean giving compliments; rather, it means validating patients’ self-esteem by inviting their ideas about the health issues you are discussing. Even if patients don’t have anything more to contribute, the act of asking for their thoughts is a huge deposit in the relationship account.

NPPES - Keeping It Safe and Keeping It Updated

This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). CMS recommends that health care providers, including individual physicians and Non-Physician Practitioners (NPPs):

• Know and maintain their NPPES user IDs and passwords.
• Reset their NPPES passwords at least once a year. See the NPPES Application Help page regarding the “Reset Password” rules. Those rules indicate the length, format, content and requirements of NPPES passwords.
• Review their NPPES records to ensure the information reflects current and correct information.

Maintaining NPPES Account Information for Safety and Accessibility – Health care providers, including physicians and NPPs, should maintain their own NPPES account information (i.e., user ID, password and secret question/answer) for safety and accessibility purposes.

Viewing NPPES Information – Health care providers, including physicians and NPPs, can view their NPPES information in the following ways:

• Access the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do, follow the NPI hyperlink and select “Login.” The user will be prompted to enter the user ID and password that was previously created.*

 *If the health care provider has forgotten the password, enter the user ID and click the “Reset Forgotten Password” button to navigate to the Reset Password page. If the health care provider enters an incorrect user ID and password combination three times, the user ID will be disabled. Please contact the NPI enumerator at (800) 465-3203 if the account is disabled or if the health care provider has forgotten the user ID.

• Access the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do. The NPI Registry gives an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. Health care providers can search for their information using the name or NPI as the criterion.

Updating NPPES Information – Health care providers can correct, add or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do, following the NPI hyperlink and selecting “Login.” The user will be prompted to enter the user ID and password that was previously created.

Please note that required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the Web, requiring the change/update to be made via paper application. The paper “NPI Application/Update Form” can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Need More Information? – Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found at http://www.cms.hhs.gov/NationalProvIdentStand/ on the CMS Web site. All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the page. Providers can apply for an NPI online at https://nppes.cms.hhs.gov/NPPES/Welcome.do or call the NPI enumerator to request a paper application at (800) 465-3203.

New tax law - Emergency Economic Stabilization Act

On October 3, 2008, President Bush signed the "Emergency Economic Stabilization Act," which included an AMT "patch" and extension of a number of popular tax breaks, most of which had expired at the end of 2007. Here's a quick summary of provisions extended through 2009.

 

* Deduction for state and local sales taxes in lieu of deducting state and local income taxes.

 

* $2,000 / $4,000 above-the-line deduction for higher education tuition and fees.

 

* Business tax credit for research and development expenditures.

 

* 15-year recovery period for certain leasehold improvements.

 

* Tax-free contributions from IRAs to charities by taxpayers aged 70½ and older.

 

* The additional standard deduction for property taxes  paid by those who don't itemize.

 

The law also extended some energy tax credits and deductions and provided additional tax relief for victims of disasters in federally declared disaster areas.

 

For 2008, the AMT exemption amounts are increased to $46,200 for singles and to $69,950 for joint filers.

First-time med school applicants down

As first reported by Modern Healthcare's Daily Dose newsletter, enrollment figures may be up, but the number of first-time applicants to U.S. medical schools declined slightly this year, according to new data released by the Association of American Medical Colleges. This obviously could impact recruitment of physicians in the future.

First-year enrollment at the nation’s medical schools in 2008 increased nearly 2% over 2007 to more than 18,000 students, the highest enrollment in history, the AAMC reported. Various ethnic groups helped boost this figure, with the number of Latino and Native American first-year enrollees increasing by more than 10% and 5%, respectively.

The AAMC reports that more than 42,200 applied to medical schools in 2008. While the overall applicant pool is one of the largest in more than a decade, “the number of first-time applicants decreased by 3%,” the association reported. On average, there were more than two applicants for every available opening at a medical school.

“In a time of great economic uncertainty, interest in the healing profession of medicine remains stable,” said AAMC President and Chief Executive Officer Darrell Kirch, summarizing the results in a written statement.

According to the AAMC, applicants to medical school this year were among the most academically qualified in history. There was also an increase in the number of applicants who had community service experience and medical research experience on their premedical resumes.

Automated telephone attendants

I called a physician office the other day and was greeted by the automated telephone attendant, which I don't mind in many cases, But this one droaned on and on with prompts, which I don't like. I understand why a practice would want a lot of prompts but they are a pain in the ass! Put yourself in the shoes of a patient - would you like to sit there and listen to all of that? Most would not and all it leads to is patient dissatisfaction.

So if you are going to have an automated telephone attendant,

1. Keep a tight set minimum prompts;

2. Always have the option to hit "0" for a receptionist.