Wednesday, January 2, 2013

Congress OKs cliff deal, signaling future fights

Speaker of the House John Boehner, R-Ohio, passes waiting reporters as he leaves a closed-door GOP meeting on the "fiscal cliff" bill passed by the Senate Monday night, at the Capitol in Washington, Tuesday, Jan. 1, 2013. (AP Photo/J. Scott Applewhite)

Speaker of the House John Boehner, R-Ohio, passes waiting reporters as he leaves a closed-door GOP meeting on the "fiscal cliff" bill passed by the Senate Monday night, at the Capitol in Washington, Tuesday, Jan. 1, 2013. (AP Photo/J. Scott Applewhite)

President Barack Obama winks as he arrives to make a statement regarding the passage of the fiscal cliff bill in the Brady Press Briefing Room at the White House in Washington, Tuesday, Jan. 1, 2013. (AP Photo/Charles Dharapak)

House Minority Leader Nancy Pelosi, D-Calif., the top Democrat in the Republican-controlled House of Representatives, speaks to reporters on the "fiscal cliff" bill passed by the Senate Monday night that's waiting for the House vote at the Capitol in Washington, Tuesday, Jan. 1, 2013. Democrats were meeting with Vice President Joe Biden who has been shuttling between the White House and Capitol Hill to help negotiate a legislative path to avert the across-the-board tax increases and sweeping spending cuts that could damage the economy. (AP Photo/J. Scott Applewhite)

House Majority Leader Eric Cantor, R-Va., center, leaves a second Republican caucus meeting to discuss the "fiscal cliff" bill passed by the Senate Monday night_and now awaits a vote in the GOP-controlled House_ at the Capitol in Washington on Tuesday, Jan. 1, 2013. (AP Photo/Jacquelyn Martin)

WASHINGTON (AP) ? Congress' excruciating, extraordinary New Year's Day approval of a compromise averting a prolonged tumble off the fiscal cliff hands President Barack Obama most of the tax boosts on the rich that he campaigned on. It also prevents House Republicans from facing blame for blocking tax cuts for most American households, though most GOP lawmakers parted ways with Speaker John Boehner and opposed the measure.

Passage also lays the groundwork for future battles between the two sides over federal spending and debt.

Capping a holiday season political spectacle that featured enough high and low notes for a Broadway musical, the GOP-run House voted final approval for the measure by 257-167 late Tuesday. That came after the Democratic-led Senate used a wee-hours 89-8 roll call to assent to the bill, belying the partisan brinkmanship that colored much of the path to the final deal.

"A central promise of my campaign for president was to change the tax code that was too skewed towards the wealthy at the expense of working middle-class Americans," Obama said at the White House before flying to Hawaii to resume his holiday break. "Tonight we've done that."

The bill would boost the top 35 percent income tax rate to 39.6 percent for incomes exceeding $400,000 for individuals and $450,000 for couples, while continuing decade-old income tax cuts for everyone else. In his re-election campaign last year Obama had vowed to boost rates on earnings at somewhat lower levels ? $200,000 for individuals and $250,000 for families.

Scores of GOP lawmakers voted for the measure, reversing a quarter-century of solid Republican opposition to boosting any tax rates at all.

The bill would also raise taxes top earners pay on dividends, capital gains and inherited estates; permanently stop the alternative minimum tax from raising levies on millions of middle-income families; extend expiring jobless benefits; prevent cuts in Medicare reimbursements to doctors; and delay for two months billions in budget-wide cuts in defense and domestic programs slated for this year.

Both sides lamented their failure to reach a significant deficit-cutting agreement. But neither much mentioned another omission: The immediate expiration of a two-year, 2-percentage-point cut in the Social Security payroll tax.

That break, which put an extra $1,000 in the wallets of typical families earning $50,000 a year, was an Obama priority two years ago as a way to boost consumer spending and spark the flagging economy, but it fell victim this time to other priorities.

House Democrats voted by an overwhelming 172-16 for the agreement, which was crafted over the weekend by Senate Minority Leader Mitch McConnell, R-Ky., and Vice President Joe Biden.

But Republicans tilted against it 151-85. It is rare for leaders to bring a bill to the House floor that will be opposed by most lawmakers from their own party, and the decision underscored the pressure GOP leaders felt to approve the legislation.

Boehner, R-Ohio, took no public stance on the measure before the vote. But he guided the compromise to the House floor after an unsuccessful attempt by many conservatives to persuade leaders to add spending cuts to the bill.

Had the House inserted those budget cuts and the Senate refused to consider them, the legislation could have died. That left House Republicans worried that voters might blame them for a huge, sweeping tax increase and for any swoon the nation's financial markets might take when they reopened Wednesday.

"You can be right and you can be dead right. Which is it?" said Rep. Rich Nugent, R-Fla., of the quandary Republicans faced. "Right now you need to take the tax issue off the table" and move on to a focus on curbing spending, he said.

Boehner voted for the bill, an unusual step because speakers seldom vote, and he was joined by Rep. Paul Ryan, R-Wis., the GOP's vice presidential candidate last fall. Voting "no" were the other two top GOP leaders, Reps. Eric Cantor of Virginia and Kevin McCarthy of California.

Passage came nearly 24 hours after a decade's worth of tax cuts enjoyed by tens of millions of Americans expired with the stroke of the new year, technically raising taxes by more than $500 billion in 2013 alone.

Those tax increases ? plus $109 billion in defense and domestic spending cuts that were to be automatically triggered Wednesday ? became known as the fiscal cliff. Economists warned that their combined impact would hurl the economy back into recession, but Obama's signature on the bill would prevent the "cliff" from taking hold.

Obama can sign the bill remotely using a machine called an "autopen," or the bill can be flown to Hawaii for his signature.

Overall, the legislation would add nearly $4 trillion to federal deficits over the next decade compared with what would have happened had all the tax cuts expired, according to the nonpartisan Congressional Budget Office.

"I'm embarrassed for this generation. Future generations deserve better," complained one foe, Rep. Louie Gohmert, R-Texas.

The agreement's journey to passage was a tortured one. It included negotiations between Obama and Boehner on a larger, deficit-cutting deal that collapsed, and a failed effort by the speaker to drum up enough GOP votes to pass a "Plan B" that would have limited tax boosts to incomes exceeding $1 million.

It took weekend talks between McConnell and Biden, former Senate colleagues, to craft the more modest package that focused on averting the worst impacts of the fiscal cliff while postponing any deficit reduction efforts to coming months.

Those first showdowns will come over the next three months, when the government's legal ability to borrow money will expire and temporary financing for federal agency budgets will expire. Republicans have already said that, as they did in 2011, they will demand spending cuts as a condition for extending the debt ceiling.

"Now the focus turns to spending" and overhauling the tax code, Boehner said in a written statement after the vote. He said the GOP will fight for "significant spending cuts and reforms to the entitlement programs that are driving our country deeper and deeper into debt," a reference to costly benefit programs like Medicare, Social Security and Medicaid.

In his White House remarks, Obama said that while he was open to compromise, he would demand deficit-cutting savings from added revenue on the well-off, not just spending cuts.

He also pointedly said he would "not have another debate with this Congress" over extending the federal borrowing limit.

"If Congress refuses to give the United States government the ability to pay these bills on time, the consequences for the entire global economy would be catastrophic ? far worse than the impact of a fiscal cliff," he said.

Though its focus was on taxes, the measure approved Tuesday would prevent a potential doubling of milk prices and prevent a $900 salary increase for members of Congress in March. Its extension of jobless benefits would help 2 million people out of work at least six months, and it would prevent a 27 percent cut in reimbursements doctors get for treating Medicare patients.

Weighing in with criticism of the compromise were the chief authors of an influential bipartisan deficit-cutting proposal, former GOP Sen. Alan Simpson and Democrat Erskine Bowles, a former White House chief of staff under President Bill Clinton. They called the measure "truly a missed opportunity to do something big to reduce our long term fiscal problems."

___

AP reporters David Espo, Charles Babington, Andrew Taylor and Larry Margasak contributed to this report.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/386c25518f464186bf7a2ac026580ce7/Article_2013-01-02-Fiscal%20Cliff/id-e6d155e3807c4f9a85b555f8b96430b5

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Source: http://www.businessservicessupport.com/blog/2012/12/20/vocational-education-training-by-iris0326/

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Biden May Be the Most Influential Vice President Ever

Barack Obama just can?t get enough out of Joe Biden these days. And anybody who?s been following Biden?s steady ascent in stature over the last several years -- from gaffe-happy presidential contender to one of the most powerful vice presidents in U.S. history? -- couldn?t be less surprised.

Perhaps the only surprise at all is that, in contrast to a year ago,? it took Biden quite this long to become the president?s point man on the latest round of fiscal talks. The exact reason for the delay is not clear. Perhaps it is that, only a week and a half ago, Obama had called on his vice president to lead a commission to expedite recommendations on a truly serious national issue, gun violence (as opposed to the present trumped-up issue, fiscal reform, which requires only the smidgeon of political courage necessary to depart from? ideological rigidities). Maybe Obama wanted to keep his veep?s powder dry for that.

Or maybe it is just that, in the awkward pattern of political dance partnerships that have emerged over the last couple of years, whenever Barack Obama and Speaker John Boehner fail to execute ? as they did after the ?Plan B? debacle -- it?s Biden and his old Senate colleague, Mitch McConnell, who step into the spotlight. The Biden-McConnell duo didn?t cut it during last year?s cliffhanger over the debt limit, of course. But in a sign of just how important a figure the vice president has become in Washington, Biden?s absence until now has been one reason that Republicans doubted Obama?s seriousness about cutting a deal, my colleague Chris Frates reported last week.

As the inevitable brinksmanship plays out, it?s useful to step back and look at just how central a role Biden has played throughout Obama?s presidency.

Over the past four years Biden has insinuated himself into the White House, while seeming hardly to try, in a way that no other vice president in memory has done. He and Obama, both consummate pragmatists though they tend to be liberal in outlook, have achieved something close to a mind meld across a whole range of issues, including foreign policy, the economy, and political strategy. Biden said it outright in his speech during the presidential campaign: ?I literally get to be the last guy in the room with the president. That?s our arrangement.? That?s no small thing in a town where power is often measured in minutes of presidential face time.

It wasn?t long ago that Biden?s predecessor, Dick Cheney, was seen as the gold -- some might say sulfurous -- standard in vice presidential power. Biden himself, ironically enough, once described Cheney as ?probably the most dangerous vice president we?ve had? because of what many observers saw as Cheney?s undue influence over George W. Bush.?

But in terms of the sheer number of issues Biden has influenced in a short time, the current vice president is bidding to surpass even Cheney. Fiscal issues and guns are only a small sampling of this vice president?s portfolio. Back in 2010 it was Biden?s office that, in the main, orchestrated the handover to the Iraqis. It is Biden?s view of Afghanistan that has, bit by bit, come to dominate thinking inside the 2014 withdrawal plan. On financial reform it was Biden who prodded an indecisive Obama to embrace, at long last, Paul Volcker?s idea of barring banks from risky trading, according to Austan Goolsbee, formerly the head of Obama?s Council of Economic Advisers. The VP also tilted the discussion in favor of a bailout of the Big Three auto companies, according to Jared Bernstein, Biden?s former economic adviser. ?I think he made a difference in president?s thinking," Bernstein said. "He understood the importance of the auto companies to their communities, and throughout the country.?

In an interview in the fall of 2010, Biden could hardly contain his enthusiasm for his partnership with Obama. The phrase ?Barack and I ? ? fell from his lips naturally, with no hint of diffidence. He told me then that to his continuing surprise Obama has continued to ?turn over big chunks? of policy to him to handle, whether it?s Iraq, middle-class issues, overseeing the recovery act.? At an early meeting, ?all of sudden Obama stopped. He said, ?Joe will do Iraq. Joe knows more about Iraq than anyone.?. The [Economic] Recovery Act, he just handed it over? to Biden, according to a senior administration official who attended the meetings and would talk about internal discussions only on condition of anonymity.

All of this power makes for quite an irony. Until his ascent to veep, Joe Biden was largely known as an amiable guy with a brilliant smile and a rather big mouth in which he frequently inserted his foot. And it?s not as if anyone could have expected that he?d be much more impressive as vice president. The vice presidency is a job that has tried to be taken seriously throughout U.S. history?and usually failed. John Adams, the nation?s first vice president, bitterly derided his job as ?the most insignificant office that ever the invention of man contrived.?? Like Adams, it was often men who had tasted real power who had the most disdain for the job. John Nance Garner, a former House speaker and FDR?s equally slighted No. 2, declared the job wasn?t ?worth a bucket of warm spit? (it?s believed he used an even saltier term). In modern times the vice presidency began to grow in stature, especially as the hair-trigger calculus of the Cold War required presidents to keep their putative replacements informed. But the job remained for the most part a funeral-attending, snooze-inducing post, barren of almost all constitutional duties.

The previous two vice presidents, Cheney and his predecessor, Al Gore, significantly changed that power dynamic. But on Biden?s watch the ?OVP??Office of the Vice President-- has become something even more: almost a conjoined twin to the presidency, organically linked and indivisible from the Oval Office. Cheney succeeded for a time by creating a kind of shadow presidency, yet there?s nothing shadowy about Biden. Indeed Biden remains, in many respects, the anti-Cheney.

Yet in two critical respects the Delaware Democrat?and the Wyoming Republican do resemble each other. Both are known to be confident in pushing their views, and both became masters of the Washington insider game. Whereas John Adams was not invited to participate in meetings of George Washington?s Cabinet, Biden handles so many issues that when, say, the national security team leaves the Oval Office, he is often left alone chatting with Obama because he needs to be part of the discussion when the economic team arrives to brief the president. He will also often sit down with Obama in the residence before an important National Security Council meeting.?

Now, if Barack Obama does leave a lasting legacy on gun violence that comes out of the terrible tragedy in Newtown, Conn., Biden will be a big part of it. And if anything like an agreement is reached on fiscal issues, Biden is likely to be part of? that as well. His long Senate tenure, and the many relationships he developed across the aisle, are once again proving crucial.? As I reported in the fall of 2010, shortly before the looming congressional election that gave the Republicans?and the Tea Party?the House, no one has more experience working with the other party, reaching across the aisle, and that talent may be critical to just keeping the government going in the coming months. ?He can sit down in foreign policy or other issues and find a common interest and drive the ideas forward. Look at what he did with Jesse Helms and Strom Thurmond? in passing the chemical weapons treaty and crime bills, respectively, in the ?90s, his former chief of staff (and later successor), Ted Kaufman, noted back then. ?I mean, Jesse Helms and Strom Thurmond! You don?t get more conservative than that.?

Actually, you do, as the current breed of Republicans has demonstrated in this era. But if anyone can talk to Mitch McConnell, it?s Joe Biden. Whose stock is still rising steadily.

Source: http://news.yahoo.com/biden-may-most-influential-vice-president-ever-133153208--politics.html

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Tuesday, January 1, 2013

No fuel sheen, no sign that hull is breached

In this photo provided by the U.S. Coast Guard, the mobile drilling unit Kulluk is towed by the tugs Aiviq and Nanuq in 29 mph winds and 20-foot seas 116 miles southwest of Kodiak City, Alaska, Sunday, Dec. 30, 2012. The crews remain stationed with the drill rig Kulluk Sunday 20 miles from Alaska's Kodiak Island as they wait in rough seas for another tug boat to arrive. The Coast Guard says the goal is to tow the Kulluk to a safe harbor and determine the next step. (AP Photo/U.S Coast Guard, Chris Usher)

In this photo provided by the U.S. Coast Guard, the mobile drilling unit Kulluk is towed by the tugs Aiviq and Nanuq in 29 mph winds and 20-foot seas 116 miles southwest of Kodiak City, Alaska, Sunday, Dec. 30, 2012. The crews remain stationed with the drill rig Kulluk Sunday 20 miles from Alaska's Kodiak Island as they wait in rough seas for another tug boat to arrive. The Coast Guard says the goal is to tow the Kulluk to a safe harbor and determine the next step. (AP Photo/U.S Coast Guard, Chris Usher)

In this photo provided by the U.S. Coast Guard, the tug Aiviq travels at just under 2 mph with the mobile drilling unit Kulluk in tow 116 miles southwest of Kodiak City, Alaska, Sunday, Dec. 30, 2012. The crews remain stationed with the drill rig Kulluk Sunday 20 miles from Alaska's Kodiak Island as they wait in rough seas for another tug boat to arrive. The Coast Guard says the goal is to tow the Kulluk to a safe harbor and determine the next step. (AP Photo/U.S Coast Guard, Chris Usher)

Shell Oil incident commander Susan Childs, second from right, answers a question about the Monday night grounding of the Shell drill ship Kulluk at a press conference on Monday, Dec. 31, 2012, at the Mariott Hotel in Anchorage, Alaska. Looking on are Shell Alaska spokesman Curtis Smith, standing, Coast Guard Commander Shane Montoya, state on-scene coordinator Alan Wien, and Garth Pulkkinen of Noble Corp., the operator of the Kulluk. The drifting Shell drill ship that broke loose from tow vessels during a severe Gulf of Alaska storm ran aground Monday in shallow water off Sitkalidak Island, company officials said. (AP Photo/Dan Joling)

(AP) ? Crews aboard two aircraft flew over an oil drilling ship Tuesday that went aground in a severe Alaska storm and saw no sign that the vessel was leaking fuel or that its hull had been breached.

The Royal Dutch Shell drilling rig used this summer in the Arctic was aground off a small island near Kodiak Island, where the ship, the Kalluk, appeared stable, said federal on-scene response coordinator Capt. Paul Mehler.

"There is no sign of a release of any product," Mehler said during a news conference at unified command center at an Anchorage hotel.

When the storm eases and weather permits, the plan is to get marine experts onboard the Kulluk to take photos and videos, and then come up with a more complete salvage plan.

The rig ran aground Monday on a sand and gravel shore off an uninhabited island in the Gulf of Alaska.

Mehler said the Kulluk is carrying about 143,000 gallons of diesel and about 12,000 gallons of lube oil and hydraulic fluid.

A Coast Guard C-130 plane and a helicopter were used to fly over the grounded vessel on Tuesday morning. The severe weather did not permit putting the marine experts on board the drilling rig, which is near shore and being pounded by stormy seas.

Mehler said there was a team of about 500 people working on a response to the situation "with many more coming."

The goal remains to get salvagers aboard the Kulluk and the ship refloated, he said.

A Shell official said the drilling rig was built with a double-sided hull of reinforced steel that is 3 inches thick. It recently had undergone $292 million in improvements before being put into service for a short time this past summer in the Beaufort Sea off Alaska's north coast.

Stormy weather eased Tuesday with waves 25 to 30 feet and winds reduced to about 35 mph. Winds were 70 mph and waves had reached 50 feet overnight, the National Weather Service said.

The drilling rig's difficulties go back to Thursday when it separated from a towing vessel south of Kodiak Island as it was being towed to Seattle for maintenance. The rig grounded Monday night on a sand and gravel shore off the southeast side of Sitkalidak Island, an uninhabited island in the Gulf of Alaska.

Sean Churchfield, operations manager for Shell Alaska, said once the situation is under control an investigation will be conducted into the cause. He did not know whether the findings would be made public. The Coast Guard said it also would be investigating and its findings would be public.

U.S. Rep. Ed Markey, D-Mass., who is the top Democrat on the Natural Resources Committee, issued a statement Tuesday expressing his concerns about the Kulluk situation.

"Oil companies keep saying they can conquer the Arctic, but the Arctic keeps disagreeing with the oil companies," Markey said. "Drilling expansion could prove disastrous for this sensitive environment."

The Kulluk was being towed Monday by a 360-foot anchor handler, the Aiviq, and a tugboat, the Alert. The vessels were moving north along Kodiak Island, trying to escape the worst of the storm. About 4:15 p.m., the drill ship separated from the Aiviq about 10 to 15 miles off shore. The tug boat crew guided the drill ship to a place where it would cause the least environmental damage and cut it loose. It grounded at about 9 p.m.

____

Associated Press staff writers Dan Joling in Anchorage and Donna Blankinship in Seattle contributed to this story.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/f70471f764144b2fab526d39972d37b3/Article_2013-01-01-Shell-Arctic%20Drill%20Ship/id-1b4f16352c62441186ff24cb1e53dd98

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Physicians to Manage Revenues amidst the Impending 26.5 ...

Ever since Sustainable Growth Rate (SGR) began overshooting budgeted Medicare spend, physicians have been under the constant threat of Medicare cut. While Congress? intervention has delayed the inevitable thus far, it may be a little tougher this time ? Centre for Medicare Services (CMS) has already indicated that its fee schedule for 2013 is designed to initiate 26.5% Medicare cut if the Congress fails to intervene before Jan. 1, 2013. While physicians may still be optimistic of a breakthrough in their favor, they still need to be prepared for any eventuality. And if 26.5 Medicare cut is indeed set in motion, it would have a debilitating effect on physicians? clinical and operational efficiency ? practices may not be able to support operational expenditure, leave alone the thought of ?profit?.

Despite the looming fear, practices can still find ways to off-set the impact of Medicare cut ? transition to new payment and delivery models will help meeting the primary objective of improving patient care as well as moving to a higher-performing Medicare program.

Accountable Care Organization (ACO) is one such care model, which will increasingly become mandatory for care providers in the Medicare network. ACO requires physicians to form a clinical network that can achieve optimum clinical efficiency at minimum cost to patients. ACO works on the formula that a clinical network with A-Z medical services can considerably bring down patients? medical expenditure. While physicians in an ACO get to be recognized for high performance, they also stand to benefit from shared-savings. Moreover, being in an ACO is indeed helpful in building credibility among patients.

The provision of Affordable Care will also help physicians counter the impact of Medicare cut. The significant thing about this reform is that it extends Medicare to every uninsured citizen in U.S. With roughly one-third of population expected to be Medicare beneficiaries, physicians can look forward to off-set Medicare cut with operational volumes from Affordable Care provision.

But transiting to these novel care models may be seemingly difficult for physicians who have been used to protective health care models. Amongst possible challenges, understanding fee schedule, negotiating and renewing payer contracts, being conversant with multiple payer policies, and striking beneficial deal with payers will be more important. Moreover, a proper mix of public-private payers is more than advisable.

And, amidst these Medicare-cut-generated challenges, mandatory EHR, PQRS, and ICD-10 & HIPPA 5010 compliant coding too will add to the burden, which may be far too much to bear for physicians. With the in-house staff incapacitated to take responsibility of this enormity, outsourced medical billing services seem to be the only way out. Medical billing companies ? with experience and competence in stage-managing transformation to high-performance Medicare models, managing mandatory EHR, PQRS, and ICD-10 & HIPPA 5010 compliant coding on behalf of physicians who are essentially focused on clinical efficiency ? could provide helping hand.

Medicalbillersandcoders.com has time and again demonstrated its worth as being most reliable, flexible and transformation source for physicians? billing and operational issues. Over the years, we have successfully helped practices of varied sizes and disciplines ease through operational hurdles. And, at a time when physicians are confronted with the impending 26.5% Medicare cut, we are committed to help them counter the impact with alternative and profitable operational practices. Our broad-base of resources ? comprising competent medical billing professionals, who are conversant with dynamics of Medicare and other payer systems ? essentially drives our mission across all the 50 states in U.S.

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Video: Now a seasoned royal, Kate prepares for motherhood

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