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While we have all been aware of "issues" (complaints and concerns, including pricing) with the Affordable Care Act since its passage, only today has there become some likelihood of a major overhaul or repeal. Donald Trump, the candidate, had said he'd repeal the ACA (his name – "Obamacare"). As President, he actually does not have that power, but Congress does, and Congress now appears to be totally a Republican-controlled institution, starting in January.  

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The United States Department of Health and Human Services, Office for Civil Rights ("HHS"), which enforces the Federal standards that govern the privacy of individually identifiable health information has concluded an action against St. Joseph Health ("SJH"), based on HIPAA violations that resulted in a $2.14 million settlement. The government's announcement stated, in part, : "St. Joseph Health (SJH) has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules following the report that files containing electronic protected health information (ePHI) were publicly accessible through internet search engines from 2011 until 2012". This violation was self-reported by SJH to HHS in February 2012 and has been under investigation, and in settlement discussions, of most of the intervening time. 

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On October 1, 2016, the new changes to Section S of the MDS (Minimum Data Set) for the State of Illinois will go into effect. These updates are significant changes and, unlike the prior Section S, this new item set will require corroboration between social services and the clinical team. If you haven't already, now is the time to establish a process to accurately fulfill this requirement: compliance in this area will eventually be reported, enforced, and impact Medicaid reimbursement.

Section S is a State defined Section of the MDS 3.0 and is required for each MDS submitted to the national repository and ultimately the Illinois Department of Healthcare and Family Services (HFS). 

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The Department of Healthcare and Family Services (HFS) announced on August 24, 2016 that they are expanding enrollment for the Supportive Living Program for dementia care settings for experienced healthcare providers. The application process will require interested parties to demonstrate experience in working with individuals in a dementia care setting.

Dementia care patients are those who have a mental inability that is severe enough to prevent an individual from being able to perform normal activities of daily living. Diagnosis that are commonly found in dementia care patients include Alzheimer's, Parkinson's, Huntington's disease, or mixed dementia.  

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In response to the industry concerns regarding Call Reporting preparation and related costs, the FFIEC has approved burden-reducing revisions to Call Reports effective September 30, 2016 and March 31, 2017.  These revisions still need to be approved by the U.S. Office of Management and Budget and the FFIEC made some minor modifications since the revisions proposed in September 2015.     

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As everyone in the financial institution industry is knee-deep in its analysis of the new Current Expected Credit Loss ("CECL") model guidance issued by the Financial Accounting Standards Board ("FASB") in June 2016, the questions on every financial institution's finance team are: "What model should I use?" and "What data do I need?"  The FASB did not specify which model or methodology should be used and as a result, it is at the discretion of the financial institution to choose the correct model that fits that institution's loan portfolio and risk profile, as well as the skills, experience and knowledge of the finance team and the cost/benefit of running the institution.  

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A potential convergence of multiple negative trends in the commercial real estate market could create added volatility as slowing growth in China, depressed oil prices and debt maturities threaten to reduce U.S. commercial real estate prices by as much as five percent during the next year.  Even the largest property market in the U.S. (New York) is expected to see a significant reduction in real estate transactions this year.  Moreover with the added issues present in the commercial mortgage-backed securities markets, price growth has continued to be reduced.      

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The results of the recent American Banker/Reputation Institute Survey of Bank Reputations showed that in the reputation rankings of banks –large, regional and nontraditional- large banks come in third place in the overall rankings. As the economy is improving there seems to be a consistent rise in the overall reputation of banks and we are seeing large banks starting to make a comeback. Large banks are developing strategies to improve their ranking and are striving to enhance their customer reputation. It would also be expected that regional and nontraditional banks begin a push to enhance their reputations as well, which should drive improvements in the industry as a whole. 

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Health care industry manufacturers reported $7.52 billion in payments and ownership and investment interests to physicians and teaching hospitals in 2015.  

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At a time where costs are rising and margin pressure continues to grow, certain institutions consistently perform above the rest. These top performers have specific common characteristics that drive their success. All of these common characteristics relate to the leadership and culture that management creates within the institution. Financial institution management should use the top performing institutions as role models, identify the keys to their success and implement strategies that will fit within the environment of their own institution.  

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FINANCIAL INSTITUTIONS
HEALTH CARE LEGISLATIVE UPDATE
 
 
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