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Withdrawal/Redaction Sheet
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001. list
Washington Mission Participant Roster (partial) (1 page)
04/28/1995
b(6)
COLLECTION:
Clinton Presidential Records
Office of the First Lady
Jennifer Klein
OA/Box Number: 12507
FOLDER TITLE:
Speeches-Carol Meetings
2014-0536-S
kc1339
RESTRICTION CODES
Presidential Records Act (44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRA]
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information |(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA|
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy |(a)(6) of the PRA
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
Get F $ 4 info fared
from HITS
TO:
Carol Rasco
FROM:
Jennifer Klein
DATE:
5/16/95
RE:
Jewish Federation of Greater Springfield, Inc.
On Thursday, May 18 at 10:30 in Room 450, we are meeting with a group who are
on a trip sponsored by the Health Professional's Division of the Jewish Federation of
Greater Springfield, Inc. (see attached list). As you may remember, this meeting was
requested by Congresswoman DeLauro's office. Most of the members of the group are
health professionals including an orthopedic surgeon, a cardiologist, a general
practitioner, an internist, an obstetrician-gynecologist, a dentist and a health lawyer. There
will also be a stockbroker and some business people.
You have been asked to speak generally about our health care efforts (including both
the Republican budget proposals and health care reform). They have also asked about the
following issues:
1.
The Effects of Potential Medicare and Medicaid Cuts on the Health of Children
and People Over 65 Years Old
I would recommend that you focus a good part of this meeting on Medicare and
Medicaid. Of the issues they raised, this is the one we want to talk about most.
Please note that I have attached two sets of talking points. The actual Domenici and
Kasich proposals were released after we wrote the first set. Domenici would cut
$256 billion from Medicare and $175 from Medicaid. Kasich would cut $288
billion from Medicare and $184 billion from Medicaid. Gene Sperling did a second
set today that reflects these new numbers. As you can see, the rhetoric is the same
in both.
2.
Malpractice
We have not changed our policy from last year on medical liability reform. We
struck a balance last year and felt that our proposal took real steps toward reform
(through alternative dispute resolution, the collateral source rule, etc.) while
protecting the most injured plaintiffs (by not, for example, proposing caps on
damages).
We have, of course, opposed the Republicans' product liability bill particularly
caps on damages (and we noted that we would oppose caps in malpractice cases as
well as product liability actions). Because this group will most likely support caps
on damages and other more aggressive liability reforms, I would recommend that
you touch only briefly on this issue.
1
3.
Allocation of Resident Training Positions (Specialist V. Generalist)
Under the Health Security Act, the Administration proposed a Council on Graduate
Medical Education to allocate residency slots to teaching hospitals by medical
specialty. This proposal was very controversial.
Currently, we have no plans to allocate specialties. We remain committed, however,
to increasing the number of primary doctors -- particularly in underserved inner
cities and rural areas -- and HCFA is working on other ways to encourage primary
care in medical education.
4.
Stark I and II
HHS is currently finalizing regulations implementing the prohibitions in OBRA '89
on physician ownership of and referral to health care entities that furnish clinical
laboratory services (known as Stark I). They are also in the process of drafting
regulations implementing Stark II, which extends the review of referrals to other
health services (including physical therapy, radiology, home health and prescription
drugs).
Because the regulations for Stark I are currently being finalized by the
Administration, you are not permitted to discuss the regulations. You can say that
the regulations are expected to be published this summer and that they will provide
clarity in an area that you know has caused much confusion for the medical
community. You should also note that you are happy to hear their views on
physician self-referral.
5.
Antitrust Implications of Physician Joint Ventures
Physicians want clear antitrust exemptions so that they can better compete in a
marketplace increasingly dominated by managed care organizations and other
insurance companies. The Justice Department has shortened review times and, with
the Federal Trade Commission, has released nine antitrust policy statements to guide
physicians and hospitals. Generally, physicians and hospitals see these policy
statements as a good first step but believe that we have not gone far enough. Last
year, a number of Republicans supported stronger antitrust relief (best known was
the Hatch-Archer bill which delineated broad safe harbors for joint ventures and
other collaborative arrangements and provided for streamlined antitrust review).
One of the Administration's policy statements sets out safety zones for physician
network joint ventures that will not be challenged under the antitrust laws.
The Department of Justice and the Federal Trade Commission will not
challenge an exclusive (i.e., an arrangement that significantly restricts the
2
ability of its members to contract with other groups) physician network joint
venture that: (1) includes 20 percent or less of the physicians in each
physician specialty in a geographic market; and (2) requires the physicians to
share substantial financial risk.
The agencies will not challenge a non-exclusive physician network joint
venture that includes 30 percent or less of the physicians in each specialty in
the area if the physicians share substantial financial risk.
There are extensive legal tests to determine whether an arrangement is "exclusive"
on "non-exclusive" and whether the physicians share "substantial" financial risk.
Joint ventures that do not meet these tests do not necessarily raise antitrust concerns.
They are simply reviewed under traditional antitrust analysis.
Please feel free to call me at work (6-2599) or at home (265-8398) with any questions.
3
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001. list
Washington Mission Participant Roster (partial) (1 page)
04/28/1995
b(6)
COLLECTION:
Clinton Presidential Records
Office of the First Lady
Jennifer Klein
OA/Box Number: 12507
FOLDER TITLE:
Speeches-Carol Meetings
2014-0536-S
kc1339
RESTRICTION CODES
Presidential Records Act [44 U.S.C. 2204(a)|
Freedom of Information Act 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRAJ
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRA]
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information |(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors. or between such advisors |a)(5) of the PRA
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy |(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions |(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
Washington Mission
[00]]
May 18, 1995
Participant Roster As Of 4/28/95
Name
Address
Home #
Bus. #
DOB
Berman, Geoffrey
135 Pinewood Drive
567-6891
736-3671
Longmeadow, MA 01106
Broder, Martin
168 Inverness Lane
567-1920
784-4318
Longmeadow, MA 01106
Cooper, Scott
107 Whittier Street
785-1153
Northampton, MA 01060
Engelson, Richard
31 Woodside Drive
567-5830
Longmeadow, MA 01106
Engelson, Abraham
31 Woodside Drive
567-5830
Longmeadow, MA 01106
Feinstein, Michele
601 Williams Street
567-0233
781-0472
Longmeadow, MA 01106
Hausman, Howard
96 Pinewood Hills
567-6308
567-1223
Longmeadow, MA 01106
Hellerman, Leonard
1264 Windsor Avenue,
203-688-1372
Windsor, CI 06095
(b)(6)
Hellerman, Bette
1264 Windsor Avenue,
203-688-1372
Windsor, CT 06095
Lundy, Laurence
40 Brooks Road
567-3408
784-5457
Longmeadow, MA 01106
Lesser, Martin
51 Greenwich Road
567-5952
536-7040
Longmeadow, MA 01106
Nassau, Merril
40 Glenbrook Road
West Hartford, CT 06107
Shifrin, David
213 Tanglewood Drive
567-8867
784-8470
Longmeadow, MA 01106
Sklar, Joseph
210 Park Drive
567-0474
785-4666
Longmeadow, MA 01106
Staff:
Catherine Schwartz
Judith Novenstein
FACT SHEET ON LIKELY REPUBLICAN MEDICAID CUTS
Wednesday, May 3, 1995
Congressional Republicans are currently considering cuts in federal Medicaid funding of $160
to more than $190 billion between 1996 and 2002. Republicans claim they are not cutting the
program, but reducing its rate of growth. Yet, these technical number disputes avoid the real
issue: how their proposals will affect real Americans; who will be hurt; who will lose
coverage; and who will lose benefits if their cuts are made. It also ignores the fact that 3 to
4% of growth in Medicaid is due not to inflation but to additional children, elderly, disabled
and others being insured under the program.
Impact on Working Families. Most people think Medicaid helps only low-income mothers
and children. In fact, about two-thirds of Medicaid funds are spent on services for elderly
and disabled Americans. Without Medicaid, working families with a parent or spouse who
need long-term care would face nursing home bills that average $38,000 a year.
Insufficient Managed Care Savings. Savings from managed care cannot produce the
magnitude of cuts Republicans have proposed. Two-thirds of Medicaid funds are spent on
the elderly and disabled, and there is little evidence that putting them in managed care can
produce savings. Because the baseline projections already assume that a growing number of
mothers and children on Medicaid will be in managed care plans, there are little additional
savings left in the remaining one-third of the program.
State Finances. Republicans say these cuts merely give states additional flexibility through
block grants. Issues of flexibility can't mask the inevitable fact that states are being asked to
absorb enormous cuts -- forcing them to choose between cuts in education, law enforcement,
health care or other priorities.
Cuts in Eligibility, Benefits and Provider Payments. What do these cuts really mean?
Even accounting for some managed care savings, they mean deep cuts in eligibility, benefits
and payments to doctors, hospitals, nursing homes and other health care providers. If the
Republicans cut $160 to $190 billion between 1996 and 2002 and those cuts were divided
evenly between eliminating eligibility for elderly and disabled beneficiaries, eliminating
eligibility for children, cutting services, and cutting provider payments, that would mean --
in the year 2002 alone -- that:
5 to 7 million children would lose coverage; and
800,000 to 1 million elderly and disabled beneficiaries would lose coverage; and
Tens of millions of Americans would lose benefits, because all preventive and
diagnostic screening services for children, home health care and hospice services
would be eliminated -- as well as dental care if the cuts reach $190 billion; and
Already low payments to health care providers would be reduced by $10.7 to $12.8
billion.
FACT SHEET ON LIKELY REPUBLICAN MEDICARE CUTS
Wednesday, May 3, 1995
Congressional Republicans are considering proposals that would cut Medicare funding by
between $250 billion and $305 billion between now and 2002. Medicare cuts at this level
translate into 20% to 25% cuts in 2002 alone for this program serving our most vulnerable
Americans -- the elderly and disabled.
Choice or Coercion? Republicans claim their proposals would increase choice by giving
vouchers to Medicare beneficiaries to buy insurance in the private market. In reality, the only
way that this approach can achieve the magnitude of savings being contemplated is to
significantly raise costs for traditional fee-for-service coverage, effectively
forcing many beneficiaries to use vouchers to buy managed care. That would put Medicare's
37 million beneficiaries, many of whom have pre-existing conditions, into the private
insurance market to shop for what they can get. That is simply a form of financial coercion.
Current Health Care Spending by Older Americans. Today, despite Medicare benefits,
health care consumes major amounts of older Americans' income. According to the Urban
Institute, typical Medicare beneficiaries already dedicate a staggering 21% (or $2,500) of
their incomes to pay for out-of-pocket health care expenditures.
More Out-of-Pocket Payments: If these cuts are distributed evenly between providers and
beneficiaries, Medicare beneficiaries would pay:
$815 to $980 more in out-of-pocket expenses in 2002.
Between $3,100 to $3,700 more in out-of-pocket over the 7 year period.
Social Security COLAs: The Republicans claim they aren't cutting Social Security, but these
Medicare cuts would effectively do that. By 2002, the typical Medicare beneficiary would
see 40 to 50% of his or her cost-of-living adjustment eaten up by the increases in Medicare
cost sharing and premiums. In fact, about 2 million Medicare beneficiaries would have 100%
or more of their COLAs consumed by the cost increases.
Rural and Inner City Hospitals. Cuts of this magnitude, combined with the growing
uncompensated care burden (exacerbated by Medicaid cuts and increases in the number of
uninsured), would place rural and inner-city providers in jeopardy because they have limited
or no ability to shift costs to other payers. These cuts would threaten both the quality and
access to needed health care in rural America.
THE PRESIDENT'S REASONABLE APPROACH TO THE BUDGET
BUDGETS ARE ABOUT RAISING STANDARDS OF LIVING FOR WORKING
AMERICANS--AND THE PRESIDENT'S BUDGETS HAVE MOVED TOWARD
THAT GOAL. The test for a budget is whether it contains the balance of policies to
enable more families to realize the American Dream. The budget is now beginning to
approach balance only because President Clinton signed a plan--over strong Republican
opposition--that is reducing the deficit by over $1 trillion over 7 years. (If not for the
deficits accumulated during the Reagan/Bush years, the budget would already be in
surplus.) Yet at the same time as he has reduced the deficit, the President has taken other
steps that are essential to raise standards of living--dramatically expanding educational
opportunity; providing a tax break to 15 million working families by expanding the Earned
Income Tax Credit; and seeking to address the nation's health care challenges.
THE PRESIDENT WANTS TO MOVE TOWARD A BALANCED BUDGET--
WITHIN A BALANCED APPROACH TO THE BUDGET. The status quo is not
acceptable. The President is committed to achieving further deficit reduction in the context
of serious, step-by-step health care reform. Yet as we reduce the deficit, the President
believes we must also expand educational opportunity, preserve tax fairness for working
families, and fulfill obligations to senior citizens.
THERE IS A RIGHT WAY AND A WRONG WAY TO REDUCE THE DEFICIT--
AND REPUBLICANS WOULD DO IT THE WRONG WAY. WE ARE INSISTING
ON THREE REASONABLE CONDITIONS FOR GOING FORWARD. President
Clinton has proven that the deficit can be cut the right way. Republicans are proposing to
cut Medicare and education in order to pay for tax breaks for the wealthiest. That is the
wrong way. The right way to reduce the deficit means three things:
1. NO TAX CUTS TARGETED AT THE WELL-OFF. The Contract with
America provides a $345 billion tax break targeted at the wealthiest--a $20,000 tax
break for the top 1%. The President will not cut Medicare and student loans to pay
for such a massive tax break for those earning over $230,000.
2. ADDRESS MEDICARE AND LONG-TERM CARE IN THE CONTEXT
OF HEALTH CARE REFORM. We need to reduce health care costs in a way
that treats seniors fairly and doesn't shift costs to the private sector-that is, with
sensible but serious health care reform. By hitting Medicare and Medicaid in
isolation--and with the deepest cuts in history--Republicans would transform
Medicare into a second-class health care system, driving up out-of-pocket costs by
$2000 per elderly couple in 2002 in order to pay for their tax cuts for the wealthy.
3. CUT THE EDUCATION DEFICIT, NOT EDUCATION. While we need a
disciplined deficit reduction path, we must be equally disciplined about reducing the
education deficit. Nothing is more important than investing in education if we care
about raising our standards of living rather than fulfilling campaign promises. The
GOP budgets assault education-- eliminating Goals 2000, national service, and
interest subsidies for college loans, while gutting or sharply cutting School-to-Work
Opportunities, Head Start, Pell Grants, Safe- and Drug-Free Schools, Chapter One,
and Job Training.
REPUBLICAN MEDICARE CUTS
REPUBLICANS PROPOSE THREE TIMES THE LARGEST CUTS IN MEDICARE
IN HISTORY TO PAY FOR THEIR TAX CUTS. The Republican Medicáre cuts--$256
billion in the Senate, $288 billion in the House--are three times larger than the largest
previous Medicare cut in history. Yet this entire cut would be unnecessary if Republicans
did not need to pay for their tax cuts. The Medicare cut makes room for most--but not all--
of the $345 billion Contract tax cut, which provides a $20,000 break to the wealthiest 1%.
REPUBLICANS WOULD RAISE HEALTH CARE COSTS TO ELDERLY
COUPLES BY OVER $2,000 IN 2002--ACCORDING TO THEIR OWN
DOCUMENTS. On May 8, the New York Times reported on Newt Gingrich promising a
"huge but painless" cut in Medicare. On May 16, the Times reported a very different story
--noting that Republican cuts "almost certainly would mean charging beneficiaries more
while squeezing payments to hospitals and other health care providers." Official documents
circulated by a leading architect of Republican Medicare cuts show that Republicans would
increase premiums, copayments, and deductibles. These changes would raise Medicare
costs by over $2,000 per couple in 2002 alone. The cuts would include:
Doubling deductibles from their current level.
Increasing premiums for 7 straight years.
Dramatically increasing co-payments (i.e., beneficiary payments for services) for
home health care and other services.
REPUBLICANS WOULD MAKE MEDICARE A SECOND-CLASS SYSTEM FOR
37 MILLION SENIOR CITIZENS, CUTTING GROWTH PER PERSON FAR
BELOW GROWTH IN PRIVATE HEALTH CARE. Republicans claim that they are
just slowing the "exploding" rate of growth in Medicare. In fact, over the next 7 years, the
cost per person in Medicare is projected to be about the same as that of private insurance.
Ignoring the problem of health care costs generally, the Republicans would simply cut the
average growth rate for a Medicare recipient far below the level for other Americans. This
means reducing quality and turning Medicare into a second-class health care system.
REPUBLICAN PROPOSALS ARE ABOUT COERCION, NOT CHOICE.
Republicans have produced no evidence that their plans can achieve significant savings
through managed care among the populations that Medicare and Medicaid overwhelmingly
serve--the elderly and disabled. Some of their proposals would provide a capped voucher
to Medicare recipients that likely would not be enough for older and less healthy seniors to
afford the coverage they need. Other proposals would raise the costs for seniors to
continue seeing the doctors of their choice--forcing them to pay money they may not have
or give up the doctors they trust. Rather than expanding choice, such proposals place a
coercive "sick tax" on the Americans who need Medicare most.
REPUBLICAN MEDICARE CUTS WOULD ELIMINATE UP TO 55% OF THE
SOCIAL SECURITY COST-OF-LIVING ALLOWANCE. Their increases in Medicare
costs will be taken directly from the Social Security checks of typical Medicare beneficiaries.
By 2002, these increases would eliminate up to 55% of the Social Security COLA.
HOSPITALS WOULD BE ESPECIALLY HARD HIT BY GOP MEDICARE CUTS.
According to the American Hospital Association, costly but crucial services like trauma care,
burn units, and intensive care units would have to be closed in many hospitals. Teaching
hospitals would receive less money per case in 2002 than in 1996 under the House proposal.
05/15/95
13:03
Jan Kla
FACSIMILE COVER SHEET
Congresswoman Rosa L. DeLauro
436 Cannon House Office Building
Washington, DC 20515
202/225-3661
Fax: 202/225-4890
DELIVER TO: Pat Romani 456-2878
FROM: Amy Schmit
DATE: 5/15
PAGES: 2
COMMENTS
Pat - I am forwarding to you a list
the Juish Fideration of greater form
of topics that the group
upresenting
their muting with Mo: Rasco on
Spring fuld would like addressed. at
Thursday. also included an their
NOTICE: This telecopy transmission and any accompanying documents may contain confidential or questions
professional affikations. Please call of you have any
privileged information. They are intended only for use by the individual or entity named on this transmis- Thank
sion sheet. If you are not the intended recipient. you are not authorized to disclose, copy. distribute or use
in any manner the contents of this information. If you have received this transmission in error, please
notify us by telephone immediately so that wc can arrange retrieval of the faxed documents.
you
13:04
08
15 '95 8:39AM JEW FED GRTR SPFLD
413 737 4348
P.1
May 15, 1995
DATE:
MS. Amy Schmigt
TO:
COMPANY:
Jewish Federation of
Greater Springfield, Inc.
202-225-4890
1160 Dickinson Street
FAX NUMBER:
Springfield, MA 01108
Margie Karlin
MIC
Telephone (413) 737-4313
FROM:
FAX (413) 737-4348
1
NUMBER OF PAGES: (INCLUDING THIS COVER SHEET)
RE: Thursday. May 18th meeting with Carol Rasco
NOTES:
Any,
Since our trip is sponsored by the Health Professional's Division of the
Jewish Federation of Greater Springfield, most members of our group are
in the health field. Included are an orthopedic surgeon, a cardiologist,
a general practitioner, an internist, an ob-gyn, and a dentist. Also
joining us are an attorncy specializing in health care law, a stockbroker
and a couple of business people.
Some of the issues that our group would like to have Carol address are:
1.
The administration's position on tort reform as related to medical
malpractice;
2.
The effects of potential medicare and medicaid cuts on the health
of children and people over 65 years old;
J.M. 3.
The administration's position on allocation of resident in training
positions (specialist vs. generalist) and the effect on career
choice. (Essentially free market versus government regulations);
J.B.
4.
Fraud and abuse issues around Stark I and II; and
5.
Anti-trust implications of physician joint ventures.
I hope this is helpful.
Do WC have a specific room in the Old Executive Building?
Looking forward to hearing from you.
FAX TRANSMISSION
MAY-17-1995 11:35 FROM ADMINISTRATOR'S OFFICE
TO
94562878
P.02
Allocation of Medical Specialities -- Specialists VS. Primary Care
Under Health Care Reform the Administration had a proposal that created a national
Council on Graduate Medical Education to advise the Secretary of HHS and to allocate
residency slot to teaching hospitals by medical speciality. (Note: this proposal was very
controverisal.)
Currently, there is no plan to allocate specialties. HCFA is working on other alternatives
to encourage primary care in medical education.
Physician Self Referral (Stark I)
The anti-kickback statute and the physician self-referral prohibitions address similar social
issues: the overutilization of Medicare services when physicians have a financial
relationship with the entity providing the services.
The safe harbor provisions set forth those payment practices and business arrangements
that will be protected from criminal prosecution and civil sanctions under the anti-
kickback provisions of the statute. The safe harbors exists to provide absolute immunity
to those arrangements which are free of abuse.
The physician self-referral provisions prohibit a physician from making Medicare referrals
for designated health services to entities with which the physician (or a family member)
has a financial relationship unless the relationship fits into one of the exceptions. The
physician self-referral provisions has no issue of intent.
MAY-17-1995 13:58 FROM ADMINISTRATOR'S OFFICE
TO
94562878 P.02
Physician Self-Referrals
Physician Ownership of, and referrals to, health care entities that furnish clinical laboratory
services (that is the official title of Stark I), should be published sometime this summer.
The good news about it is that while the Stark II rules on other health services covered under the
law is separate, the Stark I (clin lab) rule will affect how we review referrals involving any of the
"designated health services" -- those health services covered under Stark II.
DHS includes:
Clinical laboratory services
Physicial therapy services
occupational therapy services
radiology services (including MRI, CAT scans, and ultrasound services)
radiation therapy services and supplies
durable medical equipment and supplies
parenteral and enteral nutrients, equipment, and supplies
prosthetics, orthotics, and prosthetic devices and supplies
home health services
outpatient prescription drugs
inpatient and outpatient services
THE WHITE HOUSE
OFFICE OF DOMESTIC POLICY
CAROL H. RASCO
Assistant to the President for Domestic Policy
To: Jennifer K.
Draft response for POTUS
and forward to CHR by:
Draft response for CHR by:
Please reply directly to the writer
(copy to CHR) by:
Please advise by:
Let's discuss: as soon as possible
For your information:
Reply using form code:
File:
Send copy to (original to CHR):
Schedule ?:
Accept
Pending
Regret
Designee to attend:
Remarks:
ARKANSAS
Carolyn
JAN - 4 1995
HOSPITAL
800 Marshall Street, Little Rock, Arkansas 72202-3591, (501) 320-1100 or TDD (501) 320-1184
PEDIATRIC ADMINISTRATION
Terry Yamauchi, M.D.
December 29, 1994
Professor and Interim Chairman
(501) 320-1417
320-3418 3418 ( Fax)
Thomas C. East
Carol Rasco
Administrator
(501) 320-1442
The White House
1600 Pennsylvania Ave.
Washington, DC 20500
Dear Carol:
Happy New Year!
A couple questions you might help me with - the
doctors are asking about:
1. Tort Reform and
2. Universal Insurance/Health Forms
anything I can say about either issue?
I will be speaking during January in the following
cities:
Greenville, SC
1-5/6
Bellflower, CA
1-8/9
Baton Rouge, LA
1-11
Cedar Rapids, IA
1-18
Orlando, FL
1-19/21
Minneapolis, MN
1-31/2-1
Please let me know if I can be of any help to you.
Sincerely,
Juny
Terry Yamauchi, M.D.
Professor and Acting Chairman
Department of Pediatrics
TY:mc
Department of Pediatrics
University of Arkansas for Medical Sciences
Cacled
Called
Jennifer K. :
This woman is the wife of a person who has been very special in
my son's life her husband Rusty is the director of a weekend
respite program that Hamp attended once a twice a month for about
six or seven years during his school years.
I believe she and her husband will be in DC in the near future
(Roz has dates or either Julie does- I think we've been working
with them on tour time and I will probably try to have lunch with
3120-
ram
them) and I think it would be a good gesture (since I hear she is
very good on this topic) if you could offer to meet with her for
thirty minutes
I'm not sure there is a way to utilize her
services at this point but she might have some things to offer in
the way of reg reform, program barriers, etc.
I assume she can be reached at her business site for which
directory assistance could provide a number since she does not
list one.
(501)
Work # : 664-9383
Thanks,
Carol CAR
CC: Roz
Julie
February 20, 1995
Carol Rascoe
The White House
West Wing, Second Floor
Washington, DC 20500
Dear Carol,
I am very pleased to hear of your increased responsibility for health care reform. Rusty Wright
suggested that I write and offer my assistance to you. I am certain that my knowledge and
experience as a provider of home infusion services will be helpful. I would like to offer my
services to you in anyway that would benefit you and your efforts.
I have been a provider of home infusion therapy for over 10 years. I have always believed in
home care as a cost effective, quality alternative to hospitalization. I also believe it maintains
and often times restores the dignity that every human deserves, but often loses when they are
hospitalized or placed in a nursing home.
In the early 80's, when I was educating physicians on home care, I would remind them, "What
is the first thing the patient ask when you walk in the room?" It is not "How did the biopsy
look? What are my labs like today?" What they ask is "When am I going home?"
My first home patient was a 24 year old mother of two children. She lived at the end of a dirt
road in a house that you could see the ground through the cracks in the floor. She was able to
provide the majority of her care and receive TPN, a complex IV solution at home for over 8
years. I do not mean, she wasted in bed as an invalid. Her main complaint was that she was
not allowed to work. She did participate at her children's school and provided a home to them
in a small trailer near her mother.
The dollars which were saved by providing her care at home were great. The fact that she was
able to care for her children for 8 more years prevented additional expenses to the state, and just
as importantly, the children were raised with the values of a devout Christian country woman.
As you will note from my resume, I have worked with industry leaders in the development of
alternate site care. They have also been leaders in profits and circumventing regulations
developed to provide cost effective, quality care.
I am fortunate now to have the opportunity to work with quality home care providers across the
nation. These providers make me proud of health care professionals. They have each tackled
the same issues such as reductions in profit margins with increased requirements by regulatory
and accreditation organizations, and met these challenges with different methods while still
maintaining quality patient care. These experiences I will proudly share.
I have never been politically active. I have one motive: To improve healthcare in the United
States; to make a difference to the people who receive home care and the health care
professionals who provide the care.
If you find that I can assist you in your efforts, I would be very honored.
Thank you for your consideration.
Sincerely,
Brenda Wright
Brenda T. Wright
Brenda Tadlock Wright
44 Coachlight Drive
Little Rock, Arkansas 72227
EDUCATION:
University of Arkansas for Medical Sciences
1980
B.S. Pharmacy
University of Arkansas for Medical Sciences
1982
Pharmacy Residency in Nutritional Support
University of Arkansas for Medical Sciences
1989
M.S. Pharmacy
EXPERIENCE:
Specialized Clinical Services
1501 N. University, Suite 762
Little Rock, AR 72207
General Manager, Eastern Zone
December 1992 to Present
I CARE of Arkansas
5810 West 10th, Suite 100
Little Rock, AR 72204
Vice President of Operations
September 1991 to December 1992
Director of Marketing
August 1990 to September 1991
Director of Special Projects
December 1989 to August 1990
Caremark
2200 Brookwood Drive, Suite 118
Little Rock, AR 72202
General Manager AHR
March 1989 to December 1989
(Caremark Partnership)
Manager of Pharmacy Services
November 1982 to December 1989
Central Arkansas Critical Care Course
Doctors Hospital
Little Rock, AR 72205
Critical Care Instructor
February 1983 to November 1991
G.I.
Brenda Tadlock Wright
Page 2
University of Arkansas for Medical Sciences
4301 West Markham
Little Rock, AR 72202
Clinical Instructor
February 1983 to December 1989
Petty's Drugs
500 South University
Little Rock, AR 72205
Pharmacist
November 1980 to May 1982
CERTIFICATIONS AND LICENSURE:
Arkansas Pharmacy License - 6910
Zenger Miller QUEST facilitator
PROFESSIONAL AND HONORARY ORGANIZATIONS:
American Society of Hospital Pharmacist
Arkansas Pharmacist Association
Arkansas Association of Hospital Pharmacist
American Association for Continuity of Care
Arkansas Association for Continuity of Care - Past President
Phi Delta Chi Professional Fraternity
Rho Chi Pharmaceutical Honor Society
HONORS AND AWARDS:
Clinical Pharmacy Award - 1980
Smith Kline French - Arkansas
Cornerstone Award - 1985
Home Health Care of America - Southwest Region
Award of Excellence - 1986
Pharmacy Reporting
Caremark - Home Health Care of America