Alaska 1332 Waiver - Economic Analysis

The four guardrails that a successful 1332 waiver must meet are as follows: 1. Coverage - There must be at least a comparable number of individuals with coverage under the waiver as would have had coverage without the waiver. 2. Affordability – The waiver should not result in an increase in out-of-pocket spending required of residents to obtain coverage, relative to income. 3. Comprehensiveness – The waiver should not decrease the number of individuals with coverage that meets the essential health benefits (EHB) benchmark. 4. Deficit Neutrality – The waiver should not have any negative impact on the federal deficit. In this report, the first three guardrails are briefly discussed to reaffirm that the actuarial analysis conducted by Oliver Wyman demonstrates that the proposed waiver meets them. The actuarial report from Oliver Wyman projects that the proposed waiver will increase the number of individuals taking up insurance in the individual market, lower average premiums, and have no impact on the comprehensiveness of coverage. The numbers reported in the actuarial analysis are then used to help evaluate the impact that the proposed waiver will have on the federal budget.Alaska Division of Insuranc

Medicaid 1915(c) home and community-based services waivers across the states.

This article provides State-level data on the Medicaid 1915(c) home and community-based services (HCBS) waivers program. Medicaid 1915(c) waiver participants were 32 percent of the Medicaid participants in institutional care in 1997. These data document wide interstate variation in organizational oversight and program policies for the waivers. Many structural barriers to HCBS waiver growth existed. Case management services, in some form, were normative for most HCBS waiver participants, but formal mechanisms to assess client satisfaction and service quality were less common. Substantial new growth in this program may require fundamental changes in HCBS waiver policies

Administrative Balance

Two of the most discussed administrative-law theories in contemporary discussion are executive preemption and big waiver. Executive preemption is the idea that agency regulations preempt state law by extension of the federal statutes the agencies are charged with enforcing. Big waiver is the idea that Congress delegates, to administrative agencies, the power to waive statutory provisions. The constitutional questions raised by executive preemption and big waiver can be put in the following terms. Executive preemption raises constitutional issues as regulatory agencies go farther and farther away from the “clear statement” of a given statute. Thus, one wonders whether agencies are turning themselves into an unconstitutional lawmaking body. Big waiver also raises constitutional issues. To some, it inverts the traditional approach to delegation and allows regulatory agencies to, in part, cancel laws that Congress passed. Executive preemption and big waiver currently constitute two separate theories of administrative law. This paper instead argues that these theories should be thought of in tandem. Executive preemption takes rights away from the states and big waiver gives rights back. As such, these tools allow agencies to balance federalism concerns in our present era of legislative gridlock

Overpayments and the Return to Work: A Practical Guide for Benefits Planners and Advocates. NY Makes Work Pay Policy to Practice Brief #6

This article will describe: how overpayments occur; SSA’s notice requirements when they advise recipients of alleged overpayments; how the beneficiary or advocate submits a request for reconsideration or waiver; how to avoid overpayments through timely reporting of income and other events; tips for evaluating the merits of a potential request for reconsideration or waiver; and how to establish the right to a waiver where “without fault” and “hardship” must be shown

The Battle to Define the Scope of Attorney-Client Privilege in the Context of Insurance Company Bad Faith: A Judicial War Zone

[Excerpt] The attorney-client privilege is the oldest of the privileges for confidential communications known to the common law. \u27 The privilege is [d]eeply rooted in public policy, and plays a \u27vital role\u27 in the administration of justice. As such, the privilege is traditionally deemed worthy of maximum legal protection \u27 and it remains one of the most carefully guarded privileges and is not readily to be whittled down. The privilege has come under assault in the insurance bad faith context in recent decades resulting in a whittling down of the privilege for insurance companies as a target party. Over the past couple of decades, various courts have rendered significant decisions regarding implied waiver of the privilege in the insurance bad faith context. These courts have seemingly set a minimal threshold for waiver that is the functional equivalent of a per se waiver rule, a rule which is inconsistent with the strength of the protection normally provided the attorney-client privilege in other contexts involving non-target parties. In contrast, Arizona, one of the jurisdictions which previously appeared to create such a per se rule, may be, with recent intermediate court decisions, redefining the battle for the scope of the attorney-client privilege in the insurance bad faith context. The Arizona decisions on this issue serve as a case study regarding the analytic gymnastics courts have engaged in to create implied waiver in the insurance bad faith context. However, these decisions may also set the stage for the judicial combatants. Will the battle result in a return to the more conservative protections of the privilege provided in other contexts or will it end with a broad per se implied waiver in the insurance context? In Part I of this article, the attorney-client privilege is discussed generally, as well as specifically, in the context of insurer bad faith. In Part I.A, a general overview of the attorney-client privilege is presented. In Part I.B, express and implied waiver of the attorney-client privilege are discussed. The courts have disagreed on the general contours of the test to be applied in determining whether an implied waiver of the attorney-client privilege has occurred, and what should be the precise formulation for that determination. The courts have also disagreed as to when a client may be deemed to have injected privileged attorney-client communications into a case, causing an implied waiver. There are three general approaches to determine whether a litigant has impliedly waived the attorney-client privilege. Each of these approaches is discussed. In Part I.C, the article discusses general principles regarding insurance bad faith and how the direct assertion of the advice-of counsel defense results in waiver of the attorney-client privilege in that context. The nature and scope of the advice-of-counsel defense is explored. In Part II, the battle over the changing boundaries of waiver by implication is examined by comparing the case authority supporting expansion versus the development of three published decisions from the courts of Arizona. The discussion starts in Part IIA, where the expansion of waiver by implication is discussed. Part II.B examines a decision from the Arizona Supreme Court which followed the trend of substantial expansion of the waiver-by-implication rule and then examines two subsequent decisions from the Arizona Court of Appeals which have applied the Arizona Supreme Court precedent to reach two very different and arguably contradictory results. The first of these appellate decisions arguably takes the expansion of implied waiver to the next level-a per se rule triggering automatic waiver as a result of defending a bad faith case on a subjective belief of acting in good faith. The second appellate decision, however, takes a step back from the ledge and seeks to limit the prior ruling to its facts rather than creating a per se rule in those circumstances. Part II.C seeks to synthesize and define the battle in Arizona over the scope of implied waiver, discussing the chilling effect continued expansion of implied waiver can have upon the advice that insurance companies seek from counsel and how the recent decision from Arizona may serve as a warm front to thaw the chill that has been in the air for the last two decades

Waiver of Rights

Part one of this memorandum provides a summary of questions asked and comments submitted in response to the DOL request for information ( RFI ) about waiver of FMLA rights. Part two of this memorandum contains the relevant statutory and regulatory text. Part two also lists other sources cited in the comments about this topic

Effective Accountability Mechanisms for New York State's English Language Learners

In September 2011, the New York State Department of Education convened a School and District Accountability Think Tank to provide public input regarding the creation of a second generation educational accountability system for the State's Elementary and Secondary Education Act waiver application. The Asian American Legal Defense and Education Fund (AALDEF) and Advocates for Children of New York (AFC) participated in the Think Tank and submitted a set of comprehensive recommendations regarding sound accountability practices for English Language Learners (ELLs). In May 2012, the U.S. Department of Education granted New York's waiver application, which included several of AALDEF's and AFC's recommendations. We believe our ELL accountability recommendations have relevance beyond the ESEA waiver, and now release this paper which sets forth key principles for a sound ELL accountability framework in New York State

Visa Waiver Program

Since the events of September 11, 2001, concerns have been raised about the ability of terrorists to enter the United States under the visa waiver program. The visa waiver program (VWP) allows nationals from certain countries to enter the United States as temporary visitors (nonimmigrants) for business or pleasure without first obtaining a visa from a U.S. consulate abroad. Temporary visitors for business or pleasure from non-VWP countries must obtain a visa from Department of State (DOS) officers at a consular post abroad before coming to the United States. The VWP constitutes one of a few exceptions under the Immigration and Nationality Act (INA) in which foreign nationals are admitted into the United States without a valid visa

Taking \u3ci\u3eSteel Seizure\u3c/i\u3e Seriously: The Iran Nuclear Agreement and the Separation of Powers

This Article examines the constitutional validity of President Obama’s decision, as part of his 2015 agreement with Iran, effectively to repeal seventeen different sanctions provisions for the fifteen-year life of the agreement. Although Congress had legislated extensively in this area, the President effected this change by entering into a “nonbinding political agreement” with Iran and by aggregating individual waiver provisions in the sanctions laws into an across-the-board waiver of sanctions. We argue that the commitments made by the President in the Iran agreement violate a fundamental separation-of-powers limit on executive power—what we term the Steel Seizure principle,” after Youngstown—the Steel Seizure case. As the U.S. Supreme Court reaffirmed in Steel Seizure, the President does not have lawmaking power even where national security and foreign relations concerns are at stake. A vast literature has grown around Steel Seizure, especially its influential concurring opinion by Justice Robert Jackson. Yet relatively little attention has been paid to the majority view of the Justices that President Truman’s seizure order was unlawful not because it contravened any express statutory prohibition but because it flouted the congressional “plan” for addressing the particular policy issue. This aspect of Steel Seizure highlights what is particularly problematic about President Obama’s decision to aggregate authorities in the sanctions laws and to commit the United States to an across-the-board waiver of nuclear-related sanctions pursuant to his agreement with Iran. President Obama treated the waiver provisions as an invitation to end the congressionally prescribed sanctions regime for addressing Iran’s nuclear weapons program and to replace it with his own nonsanctions regime for addressing the same issue. Yet the President lacks the unilateral power to overturn Congress’s prescribed policy and to replace it with his own.The President can be viewed both as an agent and, particularly in the foreign relations area, as a co-principal with Congress. The Steel Seizure principle highlights the limits of the co-principal conception of the President’s role in foreign affairs. Once Congress has developed a legislative framework for a subject matter, that framework occupies the field; the President’s role becomes one of a responsible agent. In the Iran sanctions laws, Congress provided bounded waiver authority, acting responsibly to allow limited executive discretion rather than requiring the President to seek new legislation each time flexibility was needed. It did not, however, invite the President to override the sanctions framework altogether. An emergent literature in administrative law and U.S. foreign relations law has praised Congress’s willingness to delegate waiver authority to the President for providing needed flexibility and other policy benefits. Yet that literature recognizes that the President’s exercise of waiver authority must be carefully circumscribed to avoid enabling the President effectively to revise a statutory regime out of disagreement with Congress’s policy choices. Such limiting principles are no less necessary in the foreign affairs context, where President Obama used purported waiver authority in the Iran sanctions statutes to pursue his own policy in defiance of Congress

Statement Submitted to Environmental Protection Agency for the Public Meeting, February 22, 1978, San Francisco Regarding Modification of Secondary Treatment Requirements

The principal technical reason for having a waiver provision for secondary treatment for municipal discharges is that for some outfall systems the dilution is so high that very good ambient water quality can be achieved with less than secondary treatment. Therefore, the criteria for a waiver of the secondary treatment requirement must give full consideration to the dilution obtained by the outfall system. In a high performance outfall diffuser, such as those used by major dischargers in California and Hawaii, initial dilutions are typically 100:1, and may range up to 1000:1 in very favorable circumstances