From the Texas Medical Association website:
Both Texas Oncology and ARC, for example, already participated in most major health plans in Texas before the launch of the exchange. Because not all of those insurers explicitly invited Texas Oncology to join their new marketplace networks, the group was combing through its contracts and contacting carriers to find out how to opt out of the exchange plans. All of ARC\’s existing contracts require insurers to renegotiate with the group before including it in any new products or networks. Some payers never approached the group; others came back with lower fee schedules, which ARC declined. On the other hand, 27 percent of respondents in the MGMA survey said they are participating in the exchange because their existing contract terms required them to participate in all of an insurers\’ products under so-called \”all products\” clauses.
Because a number of Dr. Buckingham\’s contracts include such clauses, the six-physician practice, Eye Physicians of Austin, faces the prospect of renegotiation in order to opt out of certain exchange plans.
\”To me, my hands are tied, and they are making me jump off of a plank I don\’t want to jump off of. And it\’s an expensive process, and it interrupts patient care,\” she said.
via Untested Waters.
“That, they say, violates President Obama’s pledge that if you like the insurance you have, you can keep it.
“Mr. Obama clearly misspoke when he said that.”
If you’re concerned about the news that the Federal food stamp program funding will be cut 5%, take a look at this map from the June, 2013 Wall Street Journal, showing the percentage of population in each state which receives Federal food stamps.
It is accompanied by a graph of growth of food stamp enrollment depicting periods of enrollment. That bright red line is Texas’ growth, which is nearly parallel with the US average, shown as a grey-green line. (Take a look at the annual spikes of Alaska’s enrollment, which I guess is due to the disbursement of the Alaska Permanent Fund Dividend.)
But take a look at the growth since the “Stimulus” was passed by the Dem-controlled House and Senate, nearly doubling funds for food stamps and increasing the number of recipients from 28 million to 48 million.Since the increase in enrollment has been over 70%, that 5% cut in payments will not bring the spending levels back to pre-recession levels. Wouldn’t it make sense to tighten up on the eligibility requirements, rather than make an across-the-board cut?
Labor unions are poised to score the delay of an ObamaCare tax in the bipartisan budget deal emerging in the Senate.
The bargain under negotiation would make small adjustments to the healthcare law, including delaying the law\’s reinsurance fee for one year. The three-year tax is meant to generate revenue that will stabilize premiums on the individual market as sick patients enter the risk pool.
My local Canyon Independent School District, in Comal County, Texas, has a proposal for a $451 Million Bond on the ballot in November.
“”The fast-growing district’s Nov. 5 ballot initiative is more than double its largest past bond issue, a $205.8 million package approved in 2008. Its size, and a lack of specifics on when new campuses will open, is drawing criticism.””
Out of the goodness of our hearts, Texas’ voters have agreed to “freeze” taxes for our neighbors over 65 years old. Will we be repaid by Seniors’ voting for every tax hike that comes along? Our grand-children will be paying for this bond, whether or not we will. We owe those future young adults our best judgment and our restraint.
Amen to this:
“So what do we Americans do with a feral, out of control administration, misusing and abusing their authority? Well, we can start transferring power and authority out of Washington DC back to the many states. Doing this with all public lands, National Parks, National Forests, Wilderness Areas, National Monuments and everything else the feds own and operate would be a good first start. Follow it up with moving all licensing and permitting back to the states.”
“Keep your doctor?” NOT!
Physicians across the state are reeling after they were informed that they will no longer be participants in a popular Medicare program.
UnitedHealthcare sent a letter dated Oct. 2 to 810 primary care physicians and 1,440 physician specialists, telling them that the separation from its Medicare Advantage network would be effective Feb. 1, 2014.
The business, a unit of Minnetonka, Minn.-based UnitedHealth Group, said affected physicians have the right to appeal and told them that their agreements for other UnitedHealthcare networks will not be impacted.
The notification came as a surprise to the Fairfield Medical Association, which counts 1,499 physicians in its ranks.
“They’re letting 19 percent of the physicians in the network go,” said Mark Thompson, executive director of the association. “This is where insurance companies are using insurance contracts to interfere with the doctor-patient relationship.”
What might have been missed in all the emotional media coverage about the troubles people are having with the ObamaCare exchanges and the news that the IRS official shared tax information with the WhiteHouse:
Hall Ingram said a key piece of the healthcare law’s new infrastructure — the federal “data hub” — is working well.
When consumers apply for insurance and tax subsidies through an exchange, the exchange uses the data hub to draw information from several state and federal agencies to confirm applicants’ identity and calculate the subsidies they can receive.
Exchanges have successfully pinged the IRS’s servers to request income information about applicants, and the IRS has been able to respond, she said.
“As far as we can tell, and we are looking on a daily basis, it\’s operating well,” Hall Ingram said.
And BOR is a much better acronym than anything I could make up.
The Burnt Orange Report is Texas’ own quintessential leftist blog, spinning and twisting any stories or facts to make conservatives look bad.
Good little far-left Democrat media tool that the BOR is, it seems almost superfluous to note that the blog is pro-abort. However, the reason I’m bringing BOR to your attention is Part 1 and Part 2 of “Why Texas Women Need Access to Later Term Abortions by someone named Natalie San Luis.
The BOR enjoys bold exaggeration in its fonts, to highlight the most emotional rants. There are the usual facetious arguments that women need abortions after 5 months such as, “wealthy women who have the means can jump over the barriers, but more and more women can’t” and “Amniocentesis, which tests amniotic fluid for fetal abnormalities and genetic problems, is sometimes performed as late as 22 weeks.” (The babies of less than wealthy women and their mothers deserve protection, too. And amniocentesis is usually done much earlier and is still legal, just as it is at 30 weeks or 35.)
Ms. San Luis would also have us develop sympathy for doctors who fear the liability of making a decision about whether a baby’s birth defect is compatible with life.
After. 20. weeks.
Because: ” Accounting for factors like the woman’s health history and future complications, it is almost impossible to accurately guess the likelihood of fetal survival in each of these cases. “
(Maybe that’s why they can’t get local hospital privileges.)
While I can mock the poor logic of the author, it’s better to catch her repeating easily checked, but false “facts.”
The founder, President and CEO of the San Antonio Abortion facility, Whole Woman’s Health, Amy Hagstrom Miller, is quoted as saying, “We’ve seen a 10 percent increase in second trimester abortions just since the sonogram bill has passed,”.
Besides the fact that there’s only one year of data available “since the sonogram bill has passed” and went into effect in late 2011, the numbers don’t back up that statement, unless it’s local to the San Antonio facility. According to numbers from the Texas Department of State Health Services, there were 136 fewer 2nd trimester abortions in Texas in 2012 than in 2011.
Year Total Abortions 2nd Trimester Abortions 1st Trimester Abortions %1st
2012 66098 5204 60882 92.1
2011 72470 5340 67121 92.6
2010 77592 5542 72042 92.8
(I couldn’t resist showing the steady decrease in abortions in Texas, even though it horrified me to put those large numbers into the calculator.)
Did anyone else notice that there’s no obvious way to make comments on BOR?
Edit 10/10/13 – correcting punctuation, removing my own redundancies — BBN
After explaining his “history,” of posturing and hiding unpopular legislation by attaching it to another Bill, President Obama truly stumbles:
“And you know, we don’t get to select which programs we implement or not.”
Iguess it depends on the meaning of “select,” because as the article notes,
Someone was paid to put this notice on the Centers for Disease Control website! On the home page, it’s on a red background! (But don’t worry: they also have a reminder to sign up for ObamaCare.)
Due to the lapse in government funding, only web sites supporting excepted functions will be updated unless otherwise funded. As a result, the information on this website may not be up to date, the transactions submitted via the website may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted.
Updates regarding government operating status and resumption of normal operations can be found at http://www.usa.gov.
Update, 7:30 PM 10/7/13: The National Institutes of Health also has a disclaimer.
It’s not just that this is the first time that US citizens have been barred from the Lincoln Memorial due to a government shutdown, the National Parks service is barring us from scenic drives and overlooks on public and state highways, open beaches and the waters around them, and private businesses that are paying tenants of “government” lands and waters.
One former Secretary of the Interior, Gale Norton, flatly states that these decisions are political and most likely being made in the White House.
Perhaps, instead of blaming one Party or another (or increasing government involvement in something as vital and intimate as the delivery of medical care), it’s time to decide whether our government is responsible enough to own and control so much of our lands.
Update: more closings
1. The City Tavern in Philadelphia, because the Feds own the building, not the business.
2.Nauset Knoll Motor Lodge, which leases land in Cape Cod National Seashore.
3. All sorts of fishing, rafting and hiking. Search the news on any of these topics – there are too many to post.
Edited Oct 4, 2013 at 2 PM to change the picture to one that I own.
The order to shut down business that pay money to the Federal government rather than cost money came from ” ‘above the department’, which I presume means the White House” . . .
“My company, based in North Phoenix, operates nearly over 100 US Forest Service campgrounds and day use areas under concession contract. Yesterday, as in all past government shutdowns, the Department of Agriculture and US Forest Service confirmed we would stay open during the government shutdown. This makes total sense, since our operations are self-sufficient (we are fully funded by user fees at the gate), we get no federal funds, we employ no government workers on these sites, and we actually pay rent into the Treasury.”
From that blog post on Obama’s #TemperTantrum:
” However, only one of our beaches is staffed with lifeguards under normal circumstances anyway, and when the Park closes on holidays, beaches are not barricaded, nor are citations issued to beach-goers. It should also be noted, interestingly, that according to VI Coastal Zone Management Act Section 903 (b) (6), all Virgin Islands beaches are public, from the high tide mark down to the water line…”
There have never been barricades (#Barrycades ) before, but there are under #HarryReidsShutdown?
Here’s what’s happening on St. John, US Virgin Islands due to Obama’s temper tantrum. This in spite of the fact that there are few restrooms and lifeguards, normally. (I think 2 of the beaches have lifeguards.) Those mooring balls are spots for boats to tie up – they are self-serve and people put their money ($15 a night) in a drop box on the honor system.
St John, USVI, hotbed of #shutdown protest?
So it would seem, however unlikely.
Our fair island is about 70% National Park land. Our tourism industry depends largely on operations and concessions inside the park – everything from taxi tours to boat charters, from snorkeling trips to beach weddings. Visitors come from near and far, both domestic and abroad, to sit on some of the most beautiful beaches in the world. Most of all, people visit for a chance to breathe, relax, and let the rest of the world fall away for a little while.
Yesterday, all of that changed. When Congress allowed partisan politics to prevent them from reaching an agreement to fund the government, a long list of government programs and agencies were immediately shut down, including the National Park system within the Department of the Interior. In the Virgin Islands this left some 65 employees furloughed until further…
View original post 660 more words
With the help of AFSCME national and the AFL-CIO’s Washington D.C. Metro Council, the unions created the “Federal Worker’s Guide to Shutdown D.C.,” which gives the status of major points of interest.
The furloughed workers will be in green and blue union t-shirts on the Constitution Avenue side of the Natural History Museum from 10 a.m. until noon on Wednesday. If the shutdown is long and the effort is successful, they may add volunteers at other museums.
Furloughed workers will be carrying signs.
How do they justify the extra people to close the WATER around Padre Island?
“Technically, they can’t even fish in park waters, we’ll have rangers on patrol to make sure that people know the waters as well as the land that’s under are jurisdiction is closed,” he added.
Think you own your business? Not if you contract with the Federal government!
The Arizona State highway through the Grand Canyon, along with all the private businesses (hotels, restaurants, gift shops, art galleries and even the historic Grand Canyon Railroad train from Williams, Arizona) that are not dependent on money from the Federal government, are arbitrarily “Shutdown” by the Obama Administration.
GRAND CANYON NATIONAL PARK, Ariz. (AP) – The state highway that runs through the Grand Canyon is closing Thursday morning after visitors disregarded the park closure.
Residents of Grand Canyon Village still can access State Route 64.
The Grand Canyon was forced to turn away visitors after the federal government shut down.
The highway had been open to through traffic, but visitors were pulling off the road and removing barricades from overlooks to get a glimpse of the canyon.
Park spokeswoman Maureen Oltrogge says motorists also were turning around on blind corners, tour buses were parking on the roadside and visitors were darting in front of ongoing traffic.
She says the highway closure is to ensure safety and protect resources. She says anyone caught in restricted areas could receive a citation or be arrested.
The people relying on Medicare, Medicaid and Social Security didn’t fail. They (we) were sold a tax scheme (sound familiar, Justice Roberts?) that claimed to be insurance and pension plans.
If you’ve ever scoffed at the rumors that the Federal government might confiscate your retirement savings, it’s time to reconsider. And you don’t have to look to the actions of Greece, Ireland, Poland or Cyprus to do so.
I recently read a radical extension of past theories for a Nationalized health care solution to the costs of Medicare and Medicaid for the elderly: Since many elderly citizens receive more out of Medicare, Medicaid and Social Security than they paid in, and so many eventually rely on Medicaid to pay their bills, it was suggested that our government “nationalize” all Nursing Homes and Assisted Living businesses and confiscate of Senior citizen’s assets. The Feds could then expand the Veterans Administration system in order to provide housing and medical care until death.
Isn’t the entire purpose of any insurance a bet that the insured will someday need more than he pays into the fund? Couldn’t the claim be made that many Social Security beneficiaries often receive more money over their lifetimes than they paid into the funds?
Since the Federal government got into the health care business with Medicare, Congress has done everything possible to ensure that Seniors are dependent on what we now know are failures. Everyone who becomes “Medicare eligible” – turns 65 years old – faces penalties for not signing up with Medicare. Janet Reno threatened Federal charges and prosecution for any Medicare-eligible senior who dared to pay for their own health care with their own money or entered into “private contracts” with their own doctors. Their doctors faced the penalties that go with “opting out” of Medicare. For anyone planning ahead, Congress wrote laws severely limiting Health Savings Accounts.
In the meantime, Federal (and State) government(s) failed to put money aside for the future of the people who were
paying taxes that could have gone into genuine savings or the purchase of real insurance. Private insurance and pension funds acting the same way would have been shut down and the officers imprisoned for doing the same thing.
Under the “tax” of the ACA, everyone will be forced by law – and the IRS, Federal lawyers, guns and prisons – to buy “insurance” (in reality, pre-paid health care). Since the scheme is rigged to benefit the government-run exchanges, that’s how most will buy their “insurance” – or pay their tax.
When the “Affordable Care” scheme proves to be as false as Medicare and Social Security, what next? Where to stop with “nationalization” and confiscation of property? 401K’s? Private pensions? The family home and Mama’s jewelry?
Edited to clean up punctuation, order of ideas – BBN
Be sure and look at the bottom of the page in this USA Today story for the “By the Numbers,” graphic, showing that the free school breakfast and lunch programs, as well as food stamps (SNAP) are not shut down (deemed equivalent to panda cams). No wonder the Democrats are comfortable in still demanding all or nothing.
House and Senate Republicans had offered short-term funding plans to keep open national parks, the Department of Veterans’ Affairs, and other government services in the nation’s capital.
uneffected edited — BBN
Representative Louie Gohmert (Republican from my old home in East Texas) leads the way: refuse ObamaCare subsidy if you can afford it.
“House Republicans have voted for and sent the Senate two different bills, because we have been offering compromises, even to the extent of compromising with ourselves because Senate Democrats and the President have refused to negotiate at all. They have made clear that they will negotiate with Russians and Iranians, but will not negotiate with Americans.”
Harry Reid is sauntering toward a Federal gov’t shutdown at midnight, tonight.
Even though the House passed a compromise Continuing Resolution (no longer defunding Obamacare, simply delaying it) just after midnight yesterday (Sunday) morning, Harry refused to allow the Senate to gather until 2PM, DC time, today (Monday).
Then, he made his motion to table the House CR. The motion passed along strict Party lines, 54-36. Then . . . might as well wait for it . . . he announced “debate” until 4PM, DC time.
“But in some situations, you may see a redefinition of what ‘start’ means.” (Wall Street Journal quoting Obamacare consultant.)
President Obama and Democrats everywhere should be grateful to the Republicans for saving them from a huge embarrassment. Instead, the Dems continue to dig in, escalating their claims to have won a mandate on ObamaCare in 2012, in spite of the fact that the Republicans won enough seats in the House of Representatives to secure a strong majority.
House Republicans passed a new Continuing Resolution that compromises on Obamacare, by changing from refusing funding altogether to setting up a one year delay. Included in the Bill is a measure that would ensure that our military is paid in the event of a shutdown. The Bill also repeals the 2.3% tax on medical devices and the mandate that business owners with religious objections buy insurance that includes controversial “free” contraception.
The Wall Street Journal, in addition to reporting the redefinition of “start,” outlines the many ways that the Federal and State exchanges are not ready to launch Obamacare on October 1:
In the District [of Columbia], people who use the online marketplace will not immediately learn if they are eligible for Medicaid or for subsidies.
In Oregon, people will not initially be able to enroll in an insurance plan on the Web site.
In Vermont, the marketplace will not be ready to accept online premium payments until November.
In California, it could take a month for an insurer to receive the application of someone who applies for coverage on the exchange on Oct. 1.
. . . But as the launch nears, more delays are occurring. On Thursday, the administration announced a delay in the online shopping system for small businesses and confirmed that the Spanish-language site for signing up for coverage will be delayed until mid-October. Earlier in the week, officials said Medicaid applications will not be electronically transferred from the federally run exchange to states until November.
Update, January 25, 2016 Read about the endorsement from Governor Perry
“I wanted to talk about him, who he was, see if I could get a handle on Ted Cruz the man, not Cruz the caricature I’d seen through the political lens. What I found was a very different person than what I had been led to believe.”
I love what Senator Ted Cruz is doing to fight ObamaCare and the Democrats, and totally agree with his stated goal, but strongly dislike one aspect of how he’s doing it.
Unfortunately, Senator Cruz – who was absolutely correct and exactly on target 99% of the time in his 20+ hour stand in the Senate on Tuesday and Wednesday – leads his crowd in attacking fellow conservative Republicans who support the House Bill that would fully fund the Federal government except for ObamaCare. This, in spite of the fact that Cruz has said that the fight against ObamaCare is “multistaged,” praised the Bill and House Republicans for their action and even joined in Wednesday’s unanimous Senate vote to consider the Bill in the Senate.
Most people either love or hate Ted Cruz, his agenda and his Senate tactics. There doesn’t seem to be any room for distinction between the Senator, his politics, and his actions. John McCain called him a “wacko bird.” Harry Reid called Cruz an “anarchist” – along with everyone in the Tea Party. Even Dorothy Rabinowitz, of the Wall Street Journal editorial board, went overboard contrasting Cruz and Senator Mike Lee with the “sane” wing of the Republican party. Bloggers and editors, as well as politicians focus more on Cruz’ “self regard,” his certainty that he’s right and everyone else is wrong and his lack of humility, than on the fight to stem the tide of Federal overspending and government interference in our lives. (See Wednesday’s Senate floor rants of Harry Reid And Dick Durbin, with the classic propaganda technique – or possibly, classic psychological projection – of accusing your opponent of doing the worst thing that you’re doing.)
At the same time, Cruz’ supporters have gone out of their way to call any of the Republicans who didn’t “#StandWithTed,” “traitors” and “RINO’s.” They make no distinction between McCain (who is a “RINO” in my opinion), and Texas’ Senior Senator, John Cornyn, promising to “primary” the latter in 2014.
I urge Senator Cruz and all conservatives to work to build up, not tear down. Do not join the Dems in emotional attacks and accusations. Most of all, don’t turn this into a 3-sided fight between the Dems, the Republicans, and the other Republicans.
Edited to add link to article on John Cornyn. BBN
If you only read the headlines and first paragraphs of – or the inflamed comments on – the media coverage of the debate over the Federal budget, you might believe that Republican leaders in the Senate are caving to the Democrats on funding Obamacare. In fact, Senators Mitch McConnell and John Cornyn and Senate Republicans recognize and support the House Continuing Resolution which fully funds the Federal government while defunding Obamacare.
There aren’t just two sides to the story. In fact, the media reports obscure that there are three factions: Harry Reid’s Dems, Republicans who support for the House continuing resolution, and In fact, there are three factions: Harry Reid’s Dems, the Republicans who are garnering support for the House continuing resolution, and the Republican efforts led by Senator Ted Cruz to block even the House Bill by filibuster. Hopefully, Senator Cruz will acknowledge that the House CR makes his filibuster unnecessary.
The House Continuing Resolution is a good Bill, allowing the continuation of the Federal government into December. It’s true that the whole budget debate will continue — but wouldn’t it any way?
In 2008, when physicians from CareMore, an independent medical group based in Cerritos, California, heard news reports of a brutal heat wave, they began contacting their elderly emphysema patients. Physicians worried that the scorching heat would drive their at-risk Medicare Advantage patients to the emergency room. So when patients said they had no air conditioner, the physicians purchased units for them. The theory was that the roughly $500 cost paled in comparison to the cost of an emergency-department admission. As it happened, this non-medical “intervention” kept CareMore’s patients out of the hospital. But if they had needed to go and lacked transportation, CareMore would have offered a free ride.
CareMore has an expansive, counter intuitive approach to healthcare. The group fends off falls by providing patients with regular toenail clipping and by removing shag rugs—a common household risk for the elderly. Patients engage in iPhone conference calls with healthcare professionals and are remotely monitored with devices that feed data automatically to doctors; for example, patients with congestive heart failure are given a wireless scale that reports their weight on a daily basis—a key step in preventing hospitalization. They have singing pillboxes that chime when it’s time to take medications.
These unusual tactics produce enviable outcomes: CareMore’s hospitalization rate is 24 percent below average, hospital stays are 38 percent shorter than average, and the amputation rate among diabetics is 60 percent below average. Overall member costs are roughly 18 percent below the Medicare average.
Or, as my granddaughter said, “Was he BORN dumb?” We, the people, will now pay more than we were promised!
The Obamacare “train wreck” continues. Now, the NYT reports, the caps on out-of-pocket expenses–you know the “affordable” part of the Affordable Care Act–are being delayed a year
Why not “delay” the whole thing?
From the Greg Abbott Campaign website:
Communications Director Matt Hirsch speaks with Dr. Beverly Nuckols on location at The Texas Mailhouse in Austin about the negative impact ObamaCare is having on small businesses and the health care industry, while U.S. Secretary of Health and Human Services tries to sell an unworkable, expensive healthcare takeover in Texas.
(I’m a doctor, not an audio/visual expert. And I certainly can’t afford one. Since I can’t get the podcast to embed, so please go to the site. While you’re there, volunteer, donate, help out!)
From the USAToday, August 8, 2013:
When California announced that individual premiums in its health insurance exchange could be 29% lower than expected, President Obama cheered. When Indiana announced premiums might be 72% higher than before, state officials predicted doom. So who is right? Are health insurance premiums going up or down?
We don’t know, at least in part, because both sides are playing with the numbers. To be sure, natural variation exists in how state insurance markets will be affected, but consumers should also be aware of how premium comparisons are twisted to reach predetermined results. Here are five ways they have been slanted: . . .
read more via ObamaCare’s effects difficult to measure: Column.
Edited 8-9-13 – Changed the title and post to make it more clear that this is from the USAToday, not my own writing. BBN
Peggy Fikac once again proves that she’s not a reporter, and most certainly not anything like a fair and balanced media representative.
From the Houston Chronicle’s coverage of events in Austin, today:
“Obamacare is the wrong prescription for American health care, and I will never stop fighting against it,” Abbott said, joined by small business people and a doctor who also oppose the law at a company, the Texas Mailhouse.
One reason that Abbott gave for fighting the law came in response to a doctor who asked him from the audience about what Texas could do to keep the federal law from interfering with doctors’ judgment about the best way to treat their patients.
“You’re raising one of the more challenging components of Obamacare, and a hidden component in a way, and that is government is stepping in between the doctor-patient relationship and trying to tell you what you can and cannot do, interfering with both your conscience and your medical oath to take care of your patient,” said Abbott, who is campaigning to succeed Gov. Rick Perry.
That is similar to arguments raised against tighter abortion restrictions approved in special session, including a ban on the procedure at 20 weeks, along with stricter regulations on clinics and abortion-inducing drugs.
I am that doctor from the audience. Ms. Fikac is correct that I voiced concern over the Federal interference between the patient and the doctor. She’s flat wrong about Texas regulation of medicine by bring abortionists up to standards being equivalent to the
I prefaced the question by noting that it is the State of Texas that properly regulates Texas Doctors and medicine. At the State level, patients and doctors have more influence on our elected officials and the people they appoint to write regulations and enforce the law than we do on the Federal level.
I also noted that because of the increasing interference over the years by Medicare, I am concerned about the reach that this new set of regulations will have, including ever-invasive micro-reporting of patient’s private medical conditions. (I named the upcoming move to the ICD-10, which will be a nightmare, requiring doctors to make distinctions between medical conditions, out to five (5) decimal places.
As bad as the bureaucracy of the Office of the Inspector General for the Federal Health and Human Services and the Centers for Medicare and Medicaid Services have been in the past, I don’t look forward to the additional layer of IRS income verification, audits and enforcement.
We could stick closer to home, with the Texas Health and Human Services, the Texas Medical Board, and the Texas Insurance Commission!