Your target audience is an elected official who is about to make a decision regarding your particular policy issue,

Outline for Policy White paper--HSAD 410
Who am I writing for?
Your target audience is an elected official who is about to make a decision regarding your particular policy issue, two are specifies in your syllabus. You can assume a certain level of governmental knowledge, but it is your job to fully brief the official so that they can make a well informed choice.
Format:
Summary:
A one paragraph description of your policy issue and a summary of your recommendation.
Why is this such a big deal? What should we do about it? (the short version) Current Situation
The development of your policy issue, within a historical, political and factual framework.
Tell me about it! Describe the issue in detail and then give me some background. How long have we been working on this? Who is involved in this issue? What have we already tried? What are we currently doing about it?
Proposed changes
An outline of the policy options which are being discussed.
What is it that we are thinking about doing to address this problem? Lay the options out, one by one, with a brief, un-biased description.
Effect of proposed changes
An outline of the policy options which are being discussed.
How will each of the options change things? Will they work? Why or why not? Do you have any studies or statistics to back up your case? Now is the time to trot them out!
Political Implications
A discussion of groups or individuals who are in support or in opposition.
Who loves it? Who hates it? Why do they take these positions? Is there a compromise that might make them happy? What will happen to me if I choose one side or the other?
Fiscal Impact
A presentation of the potential costs and/or revenues which are associated with the policy issue.
How much? From where? Who will be doing the paying? What kind of secondary consequences are there for doing or NOT doing a particular option?
Recommended Action
Your recommendation to the policy maker about this issue. What should we do? Why?
Length:
Your paper should be 5 pages (not including cover or references)
Back-up material:
If you use a direct quotation, you should cite it in proper APA format.
From Syllabus:
Policy White Paper
Below is a brief description of each assignment, more detail will be provided in week 3. You must choose from one of the two policy topics below.
Topic #1-Nutrition and the Home Bound Elderly
“Currently, in Washington State, under the COPES (Community Medicaid Waiver, for every home delivered meal that someone receives, they “lose” ½
hour of caregiver time. This is not the case in all states. The Washington Association of Senior Nutrition Programs would like to make the case to the Aging and Long Term Support Administration that providing nutritious food can actually improve client outcomes and reduce healthcare costs. In order to do this, we need data to support our case.” From Pam Alemeida, Spokane County Meals on Wheels
Topic #2- Payment Complexities of Student Run Health Clinics
“From what I have found, it is my understanding that if the clinic (Student Teaching Health Clinic) treats Medicare eligible patients, it must enroll with Medicare. There is an option to either be a participating or non-participating provider. However, the clinic cannot completely opt out of Medicare coverage if it treats Medicare eligible patients. Per the Medicare Benefit Policy Manual, chapter 15 (Covered Medical and Other Health Services), section 40, starting on page 22, practitioners are required to submit claims on behalf of beneficiaries for all items and services they provide for which Medicare payment may be made under Part B.
There is an exception that allows certain types of physicians and providers to opt out of Medicare and thus not be required to submit claims to Medicare. However, SLPs and audiologists are not included in the list of providers are able to opt out, nor are physical therapists and occupational therapists. Thus, the clinic cannot opt out of enrolling with Medicare if it treats patients who are eligible for Medicare. EWU then must submit claims to Medicare for covered services unless “a beneficiary or the beneficiary’s legal representative refuses, or his/her own free will, to authorize the submission of a bill to Medicare. However, the limits on what the physician practitioner, or other supplier may collect from the beneficiary continue to apply to charges for the covered service, notwithstanding the absence of a claim to Medicare.”
Attached to this e-mail is a copy of the chapter I am referring to (available on Canvas). I have not yet had an opportunity to decipher whether there are different rules for the clinic, as an institutional provider, than there are for individual practitioners.
As for the sliding fee scale, I am thinking the origin of this advice is the prohibition against offering Medicare or Medicaid beneficiaries an inducement. I am attaching a Special Advisory Bulletin from the Office of the Inspector General (Also on Canvas) about this issue. Per this bulletin, EWU cannot offer “remuneration” to Medicare or Medicaid beneficiaries. “Remuneration” includes “waivers of copayments and deductible amounts (or any part thereof) and transfers of items or services for free or for other than fair market value.” As explained in the bulletin, the law is trying to protect patients from being offered gifts to influence their choice of a provider. The OIG has interpreted the regulations to allow for waivers of cost-sharing amounts based on financial need. 42 CFR 1003.101, in the definition of remuneration, allows:
The waiver of coinsurance and deductible amounts by a person, if the waiver is not offered as part of any advertisement or solicitation; the person does not routinely waive coinsurance or deductible amounts; and the person waives coinsurance and deductible amounts after determining in good faith that the individual is in financial need or failure by the person to collective coinsurance or deductible amounts after making reasonable collection efforts[.]
I read that to mean you could waive the coinsurance or deductible for an individual person after assessing his/her individual need, but you could not have a set sliding scale, as that could be viewed as “routinely waiving” the costs. What are the payment/reimbursements options for a student teaching health clinic in Spokane? Specifically how can we argue that Medicare should change to accommodate such organizations?” From Annika Scharosch, WA State Attorneys General Office.
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