The Thursday Report 3.27.14 – Humor, Referrals, and IPAs

New Corporate Filing Forms in Florida for 2014

Florida Supremes: Baby. Baby. Where Did Our Cap Go?

Free R-Rated Meet and Greet Cocktail Hour on April 7 – Secrets of the Megastars – With National Treasure Zev Buffman – Producer of 40 Broadway Shows

The Balanced Scorecard of an IPA

The Other IPA – A Balanced Beverage History

Jerry Hesch’s Triple Play

Attorney Humor!

Free Phone call to Improve Your Estate Planning and/or Tax Practice – For Lawyers Only

We welcome contributions for future Thursday Report topics. If you are interested in making a contribution as a guest writer, please email Janine Gunyan at Janine@gassmanpa.com.

This report and other Thursday Reports can be found on our website at www.gassmanlaw.com

New Corporate Filing Forms in Florida for 2014

 The Florida Department of State, Division of Corporations has updated the corporate filing forms for 2014.  For LLCs, the new forms comply with Chapter 605, Florida Statutes and the Department of State is no longer accepting the “old” forms.  Articles of Organization and Articles of Amendment for Florida LLCs using the “old” form will be rejected by the Department of State and it will be necessary to re-submit the filing using the new 2014 form to receive a filing acknowledgment.

 All of the new corporate filing forms are available on the Division of Corporations website (www.sunbiz.org).  From the home page, simply click on “Forms” from the top right tool bar and choose the entity type to pull up all available forms in PDF format.

Florida Supremes – Baby, Baby, Where Did Our Cap Go?

In a decision that has surprised and disappointed many of us, the Florida Supreme Court found that the 2003 medical-malpractice law $500,000 cap on pain and suffering damages violates the Equal Protection Clause of the Florida Constitution.

 The Court also found that the rationale for the Legislation in 2003 was based upon faulty conclusions by the Legislature when it determined that there was a shortage of doctors in Florida resulting from the malpractice crisis.

 Much has already been written about this case, which was released on March 13 (everybody’s lucky day!).

 The following excerpts from the Court’s decision should be of interest to those who have not read it:

 Estate of Michelle Evette McCall, et al., Petitioners,
                                   vs.
United States Of America, Respondent

 Lewis, J. – This case is before the Court to answer four questions of Florida law certified by the United States Court of Appeals for the Eleventh Circuit that are determinative of a cause pending in that court and for which there appears to be no controlling precedent.

 Because this case involves a wrongful death, we rephrase the first certified question as follows:

 DOES THE STATUTORY CAP ON WRONGFUL DEATH NONECONOMIC DAMAGES, FLA. STAT. § 766.118, VIOLATE THE RIGHT TO EQUAL PROTECTION UNDER ARTICLE I, SECTION 2 OF THE FLORIDA CONSTITUTION?

 As explained below, we answer the first rephrased certified question in the affirmative and hold that the cap on wrongful death noneconomic damages provided in section 766.118, Florida Statutes, violates the Equal Protection Clause of the Florida Constitution.

 In this case, the district court limited the Petitioners’ recovery of wrongful death noneconomic damages to $1 million upon application of section 766.118(2), Florida Statutes (2005), Florida’s statutory cap on wrongful death noneconomic damages based on medical malpractice claims.  Id.¹  The district court denied a motion filed by the Petitioners that challenged the constitutionality of Florida’s wrongful death statutory cap under both the Florida and United States Constitution.  Id.  The district court also denied the Petitioners’ motion to alter or amend the judgment.  Id. at 947-48.

On appeal to the Eleventh Circuit, the Petitioners challenged the district court’s rulings with regard to both the application and the constitutionality of the cap mandated by Florida law on wrongful death noneconomic damages for medical malpractice claims.  Id. at 948.

The Eleventh Circuit affirmed the application of the statutory cap on noneconomic damages and held that the statute does not constitute a taking in violation of article X, section 6, of the Florida Constitution.  Id. at 953.  The federal appellate court also held that the cap does not violate either the Equal Protection Clause or the Takings Clause of the United States Constitution.  Id.  However, the Eleventh Circuit granted a motion filed by the Petitioners to certify four questions to this Court regarding the remaining challenges to the statutory cap under the Florida Constitution.  Id. 

EQUAL PROTECTION

All natural persons, female and male alike, are equal before the law.  Art. I, § 2, Fla. Const.  This Court has stated “[t]he constitutional right of equal protection of the laws means that everyone is entitled to stand before the law on equal terms with, to enjoy the same rights as belong to, and to bear the same burden as are imposed upon others in a like situation.”  Caldwell v. Mann, 26 So. 2d 788, 790 (Fla. 1946).

Unless a suspect class or fundamental right protected by the Florida Constitution is implicated by the challenged provision, the rational basis test will apply to evaluate an equal protection challenge.

Having carefully considered the arguments of both parties and the amici, we conclude that section 766.118 violates the Equal Protection Clause of the Florida Constitution under the rational basis test.  The statutory cap on wrongful death noneconomic damages fails because it imposes unfair and illogical burdens on injured parties when an act of medical negligence gives rise to multiple claimants.  In such circumstances, medical malpractice claimants do not receive the same rights to full compensation because of arbitrarily diminished compensation for legally cognizable claims.  Further, the statutory cap on wrongful death noneconomic damages does not bear a rational relationship to the stated purpose that the cap is purported to address, the alleged medical malpractice insurance crisis in Florida.

The Alleged Medical Malpractice Crisis

In addition to arbitrary and invidious discrimination between medical malpractice claimants, the cap on noneconomic damages also violates the Equal Protection Clause of the Florida Constitution because it bears no rational relationship to a legitimate state objective, thereby failing the rational basis test.  See Fla. Nurses Ass’n, 508 So. 2d at 319.

The Florida Legislature attempted to justify the cap on noneconomic damages by claiming that “Florida is in the midst of a medical malpractice insurance crisis of unprecedented magnitude.”

In enacting the statutory cap on noneconomic damages, the Legislature relied heavily on a report prepared by the Governor’s Select Task Force on Heathcare Professional Liability Insurance (Task Force), which concluded that “actual and potential jury awards of noneconomic damages (such as pain and suffering) are a key factor (perhaps the most important factor) behind the unavailability and un-affordability of medical malpractice insurance in Florida.”  Report of Governor’s Select Task Force on Healthcare Professional Liability Insurance (Task Force Report) (Jan. 29, 2003), at xvii.

To evaluate the constitutionality of the cap on noneconomic damages imposed by section 766.118, we are not required to accept the findings of the Legislature or the Task Force at face value.

Our consideration of the factors and circumstances involved demonstrates that the conclusions reached by the Florida Legislature as to the existence of a medical malpractice crisis are not fully supported by available data.  Instead, the alleged interest of health care being unavailable is completely undermined by authoritative government reports.  Those government reports have indicated that the numbers of physicians in both metropolitan and non-metropolitan areas have increased.  For example, in a 2003 report, the United States General Accounting Office found that from 1991 to 2001, Florida’s physician supply per 100,000 people grew from 214 to 237 in metropolitan areas and from 98 to 117 in nonmetropolitan areas, or percentage increases of 10.7 and 19, respectively.  Physician Workforce: Physician Supply Increased In Metropolitan and Nonmetropolitan Areas but Geograpic Disparities Persisted, No. GAO-04-124, (October 31, 2003), at 23, available at http://www.gao.gov/new.items/d04124.pdf.  Thus, during this purported crisis, the numbers of physicians in Florida were actually increasing, not decreasing.

 Additionally, an analysis of claim activity certainly does not provide a rational basis for the clear discrimination presented by the legislation.  Although assertions of a malpractice insurance crisis are often accompanied by images of runaway juries entering verdicts in exorbitant amounts of nonecomonic damages, see, e.g., Task Force Report at xvii, one study revealed that in Florida cases which resulted in payments of $1 million or more over a fourteen-year-period, only 7.5 percent involved a jury trial verdict.

 Such statistics led the authors of the study to conclude that jury trials constitute only a very small portion of medical malpractice payments.  Id. At 1345.  The authors also concluded that “tort reform efforts focused on jury verdicts are misdirected, at least with respect to $1 million verdicts in Florida.  Not only do jury trials constitute only a small portion of $1 million payments, [but] the settlements following verdicts tend to be substantially less than the jury awards.”  Id. at 1381 (emphasis is supplied).6   Thus, available data indicates the Task Force’s finding that noneconomic damage awards by juries are a primary cause of the purported medical malpractice crisis in Florida is most questionable.

 The Task Force stated that it “believes” the alleged crisis “could get worse in the coming years…Medical malpractice insurance premiums may become unaffordable, and/or coverage may become unavailable at any price to many physicians and hospitals.”  See Task Force Report, at 211-12 (emphasis supplied).  Further, despite blaming “actual and potential jury awards of noneconomic damages” for this ominous prediction, Task Force Report at xvii, the Task Force recognized that there are other explanations for the dramatic rise in medical malpractice insurance premiums.

 For example, the Task Force Report notes that in the opinion of Joanne Doroshow, Executive Director of the Center for Justice and Democracy:

 [T]his so-called “crisis” is nothing more than the underwriting cycle of the insurance industry, and driven by the same factors that caused the “crises” in the 1970s and 1980s.  According to…Doroshow, with each crisis, there has been a severe drop in the investment income for insurers, which has been compounded by sever [sic] under-pricing of insurance premiums in the prior years… [D]uring years of high interest rates or excellent insurer profits that are invested for maximum return, the insurance companies engage in fierce competition for premium dollars by selling under-priced premiums and insuring very poor risks.  Then…when investment income drops, either due to increases in interest rates or the stock market, or due to low income resulting from unbearably low premiums, the insurance industry responds by sharply increasing premiums and reducing coverage.

 …The tort reform changes in the 1980s had nothing to do with the flattening of rates.  The flattening was caused instead by modulations in the insurance cycle throughout the country.

 Also, the deputy director of the Florida Office of Insurance Regulation testified he had found no evidence to suggest that there had been a large increase in the number of frivolous lawsuits filed in Florida, nor was there any evidence of excessive jury verdicts in the prior three years.  Testimony of Steve Roddenberry, Senate Judiciary Committee Meeting, July 14, 2003, at 3, 10.

 During the subsequent floor debate, the following dialogue occurred between a senator and the Chairman of the Senate Judiciary Committee:

SENATOR: Were you able to determine whether or not there is an access to health care crisis in terms of the number of doctors licensed to practice medicine, the number of hospital closures or the number of emergency rooms closed?

CHAIRMAN: [T]his is not what I found.  What the testimony was from both the Department of Health, the Agency for Health Care Administration and various other people…was that there, in fact, are more doctors licensed to practice today in the State of Florida than there were five years ago.

 Applications to the medical schools in the State of Florida are up and have been up consistently for the past, for the past number of years.

 And also that emergency rooms have not been closing as a result of medical malpractice.

 As a matter of fact, the Department of Health and the Agency for Health Care Administration both testified under oath that they could not cite any incidents where because of a medical malpractice crisis patients were denied some type of care or directed someplace else.

 Based upon these statements and reports, although medical malpractice premiums in Florida were undoubtedly high in 2003, we conclude the Legislature’s determination that “the increase in medical malpractice liability insurance rates is forcing physicians to practice medicine without professional liability insurance, to leave Florida, to not perform high-risk procedures, or to retire early from the practice of medicine” is unsupported.

 The Impact of Damage Caps on the Alleged Crisis

 Even if these conclusions by the Legislature are assumed to be true, and Florida was facing a dangerous risk of physician shortage due to malpractice premiums, we conclude that section 766.118 still violates Florida’s Equal Protection Clause because the available evidence fails to establish a rational relationship between a cap on noneconomic damages and alleviation of the purported crisis.

 Thus, even if there had been a medical malpractice crisis in Florida at the turn of the century, the current data reflects that it has subsided.  No rational basis currently exists (if it ever existed) between the cap imposed by section 766.118 and any legitimate state purpose.  See generally Fla. Nurses Ass’n, 508 So. 2d at 319.  At the present time, the cap on noneconomic damages serves no purpose other than to arbitrarily punish the most grievously injured or their surviving family members.  Moreover, it has never been demonstrated that there was a proper predicate for imposing the burden of supporting the Florida legislative scheme upon the shoulders of the persons and families who have been most severely injured and died as a result of medical negligence.  Health care policy that relies upon discrimination against Florida families is not rational or reasonable when it attempts to utilize aggregate caps to create unreasonable classifications.  Accordingly, and for each of these reasons, the cap on wrongful death noneconomic damages in medical malpractice actions does not pass constitutional muster.

 CONCLUSION

 Based on the foregoing, we answer the first rephrased certified question in the affirmative and hold that the cap on wrongful death noneconomic damages in section 766.118, Florida Statutes, violates the Equal Protection Clause of the Florida Constitution.

 A full copy of the decision can be viewed by clicking here.

 The good news is that as a practical matter we had caps for over 11 years, and to some extent the malpractice insurance industry actuaries have already taken the possibility of the cap being lifted into account in setting rates.

 Nevertheless, this will clearly cause significant gyrations in the next Legislative session and elections process as the trial lawyers and the medical profession gear up again to raise monies and spend political capital on a situation that is certainly not helping the practice of medicine or medical professionals.

 Whether public sentiment will be sufficient to enable those who support positions to have a Florida Constitutional Amendment to override the Equal Protection Clause remains to be seen.

Buffman

The Balanced Scorecard of an IPA
By Pariksith Singh, MD

How does one evaluate an IPA (Independent Physicians’ Association)? This is an important question not only in assessing its value for sale or acquisition but also to measure its success, review the implementation of strategy and identify its key functions and metrics. We have seen the sale of several IPAs in the recent past in Tampa Bay and an interest among physician entrepreneurs in creating IPAs and attempt to make a fast buck.  In this endeavor, they seem to look only at the financial balance sheet or returns of the organization and forget the other measurements that are key in the appraisal of an IPA.

The Balanced Scorecard (BSC) is a concept first articulated in a 1992 Harvard Business Review article by Robert S Kaplan and David Norton.  It comprises of four perspectives which are necessary to have a composite snapshot of the state of health of a business. These perspectives are:

    1. The Financial Perspective
    2. The Customer Perspective
    3. The Business Process Perspective
    4. The Learning and Growth Perspective

In the book ‘The Balanced Scorecard: You Can’t Drive a Car Solely Relying on a Rearview Mirror’, Kaplan later expanded on this approach. It is ‘estimated that at least 40% of the Fortune 1000 companies use this methodology. ‘

 In my opinion, a BSC is the best way in which one can measure the pulse of an IPA, although given the specific nature of an IPA, certain new perspectives must be added. These additional perspectives should be:

    1. The Regulatory Perspective
    2. The Legal Perspective
    3. The Brand Perspective

If an IPA deals with Medicare lives and federally-funded dollars, the regulatory aspect of its functioning assumes an even more critical metric for any violation can threaten its very existence. Such a perspective should include compliance with HIPAA, OSHA, Stark laws, anti-kickback statutes, fee-splitting, Balanced Budget Amendments, the Affordable Care Act, etc. In light of some IPAs losing their contracts with HMOs recently, such a tally becomes immediate and significant.

An IPA is nothing if not relationships and contracts. If contracts do not exist, the IPA has no foundation and its entire structure collapses. Thus, strong and compliant contracts that are transparent and clear with powerful disincentives for breach would be essential. Without such contracts in place with coherent and ethical legal counsel to back it up, an IPA would founder and be unable to grow. Whatever growth and profits are accomplished are tenuous and expose it to further danger and vulnerability. It is my recommendation that all fees including administrative and re-insurance expenses be properly disclosed and attested by affiliates at the time of induction to the IPA. It is also my belief that the liabilities to the business be considered as one of the most critical sections of the BSC, i.e., the number of lawsuits against the organization, the potential damages from such lawsuits, the confidentiality of its data and reports or their loss, the nature of competition and poaching of its affiliates, conflicts in its relationships with the HMOs and potential OIG (Office of Inspector General) investigations of its practices.

The Brand of an IPA is the ‘X’ factor, its mystique and inevitability, uniqueness and desirability, customer loyalty and credibility of the organization and its officers. It is the factor that gives it its ‘oomph’ and saleability, and without the power of the Brand, an IPA becomes an also-ran.

Thus, the valuation of an IPA cannot be done solely on a fiscal basis. All the perspectives mentioned above must be calculated and counted. While the financials remain an important aspect of any valuation, they certainly are not the most important, or even, the largest component of a BSC for an IPA. At best, the fiscal status of an IPA can be used only if the organization scores a 100 on all other measures on its scorecard. At worst, the financials have to be completely discarded if the basics of business are not in place. We have seen that recently when a Fortune 500 corporation refused to take ownership or invest in an IPA solely because there were lawsuits against it for reasons of compliance.

The fundamentals of an IPA still remain the state of its compliance, the strength of its relationships and services, its feedback systems, employees, data and processes. Without these in place and sealed protectively, all one shall find is a house of cards. And the big problem with a house of cards is that the bigger it gets, the more vulnerable it becomes to sudden collapse. An IPA has to be based on an extremely strong foundation even though it needs to be nimble and flexible as regulations change and payment methodologies vary as we have seen with CMS in recent years.

When we measure the Business Process Perspective, we should measure the MRA, HEDIS, HOS, CAHPS and care management analyses, along with length of stays, continuity of care, ER visits, close follow-ups on nursing homes and hospitals, and post-acute care and post discharge care. The Operational metrics would also study the infra-structure, the state of IT, web services, reporting and sharing of information among the executives and owners.

The Customer Perspective should pay close attention to physician and employee satisfaction and retention, response rates and reputation. When practices are not wholly owned, this becomes an even more serious concern for any IPA. Also, the strength and managed care savvy of affiliates and risk of losses due to poor utilization by them cannot be ignored. If the IPA does not see itself as a fiscal intermediary and does not have adequate protections against a downturn and that it is in a risk business where the Pareto rule can get easily skewed from 20-80 to 1-99 and if the reserves are not strong or re-insurance is weak, all the juggling of numbers is of scarce significance.

An IPA is not any stronger by randomly signing up affiliates without interest, aptitude or drive to master managed care; in fact, the very opposite is true. Without proper infra-structure in place, an IPA should not attempt to grow. The continuous education and training of its employees is a sine qua non with any growth and a culture of compliance, quality and excellence should be a part of its DNA. The best IPA is a Learning Organization and a Knowledge-Creating Organization.

The concept of a Poison Pill in the valuation of any IPA is of much use. If the risk to the IPA due to significant legal or regulatory liability is high, it completely negates any financial valuation of the IPA almost like a junk bond and, in fact, may give it a negative status. We see this frequently in the market place when we see how the credit agencies appraise a company or a nation. Recently, we have seen how Universal Health Care, Inc, a Medicare Advantage plan, was taken over by a receiver thereby reducing its value to zero and with significant legal and financial liability to its executives and owners, when the Office of Insurance Regulations (OIR) decided that the plan was out of compliance. An IPA may come under the purview of the OIR too in a similar fashion.

Eventually, one must remember that any metric is only a reflection of an overall strategy, vision and mission, and the core competence of an IPA. If the IPA loses sight of these, no amount of tactical quantification would suffice in making it healthy and sustainable. Strategy must be integrated completely with the processes and the core strength of the entity should never be compromised.  For if the core is forsaken, all is forsaken and the vitality of the organization may be irretrievably lost.

The Other IPA – A Balanced Beverage History

India Pale Ale or IPA is a hoppy beer style within the broader category of pale ale. It was first brewed in England in the 19th century. IPA was born out of necessity.  When the British were colonizing India, the beers they sent down to their troops kept spoiling during the long sea voyage. Before refrigeration and pasteurization, the brewer’s only weapons against spoilage were alcohol and hops.  Alcohol and hops provide an unfriendly environment for microbes, preventing the growth of the bacteria that causes sourness. With an extra healthy dose of hops and alcohol, both having great preservative value, their problems were solved, and the world had another distinctive beer style.

Among the first brewers known to export beer to India was George Hodgson of the Bow Brewery. Ships transported Hodgson’s beers to India, among them his October beer, which benefitted exceptionally from conditions of the voyage and was highly regarded among its consumers in India. Demand for the export style of pale ale, which had become known as India pale ale, developed in England around 1840 and India pale ale became a popular product in England.

The IPA style of beer has a whole lot going for it. First and foremost is taste, which some could argue is an acquired one. The flavor of IPA beer highlights the complex and varied results that can be achieved through hops and other beer ingredient staples. The pronounced and unique flavor profile of IPA allows for a better understanding of brewing beer in general as hops and malts are often identified individually. Today, American craft brewers do more than emulate the style. They continue to push the envelope with strength and bitterness. Curiously, it’s much harder to find a true IPA from England these days.

p>2)            The Legal Perspective

3)            The Brand Perspective

If an IPA deals with Medicare lives and federally-funded dollars, the regulatory aspect of its functioning assumes an even more critical metric for any violation can threaten its very existence. Such a perspective should include compliance with HIPAA, OSHA, Stark laws, anti-kickback statutes, fee-splitting, Balanced Budget Amendments, the Affordable Care Act, etc. In light of some IPAs losing their contracts with HMOs recently, such a tally becomes immediate and significant.

An IPA is nothing if not relationships and contracts. If contracts do not exist, the IPA has no foundation and its entire structure collapses. Thus, strong and compliant contracts that are transparent and clear with powerful disincentives for breach would be essential. Without such contracts in place with coherent and ethical legal counsel to back it up, an IPA would founder and be unable to grow. Whatever growth and profits are accomplished are tenuous and expose it to further danger and vulnerability. It is my recommendation that all fees including administrative and re-insurance expenses be properly disclosed and attested by affiliates at the time of induction to the IPA. It is also my belief that the liabilities to the business be considered as one of the most critical sections of the BSC, i.e., the number of lawsuits against the organization, the potential damages from such lawsuits, the confidentiality of its data and reports or their loss, the nature of competition and poaching of its affiliates, conflicts in its relationships with the HMOs and potential OIG (Office of Inspector General) investigations of its practices.

The Brand of an IPA is the ‘X’ factor, its mystique and inevitability, uniqueness and desirability, customer loyalty and credibility of the organization and its officers. It is the factor that gives it its ‘oomph’ and saleability, and without the power of the Brand, an IPA becomes an also-ran.

Thus, the valuation of an IPA cannot be done solely on a fiscal basis. All the perspectives mentioned above must be calculated and counted. While the financials remain an important aspect of any valuation, they certainly are not the most important, or even, the largest component of a BSC for an IPA. At best, the fiscal status of an IPA can be used only if the organization scores a 100 on all other measures on its scorecard. At worst, the financials have to be completely discarded if the basics of business are not in place. We have seen that recently when a Fortune 500 corporation refused to take ownership or invest in an IPA solely because there were lawsuits against it for reasons of compliance.

The fundamentals of an IPA still remain the state of its compliance, the strength of its relationships and services, its feedback systems, employees, data and processes. Without these in place and sealed protectively, all one shall find is a house of cards. And the big problem with a house of cards is that the bigger it gets, the more vulnerable it becomes to sudden collapse. An IPA has to be based on an extremely strong foundation even though it needs to be nimble and flexible as regulations change and payment methodologies vary as we have seen with CMS in recent years.

When we measure the Business Process Perspective, we should measure the MRA, HEDIS, HOS, CAHPS and care management analyses, along with length of stays, continuity of care, ER visits, close follow-ups on nursing homes and hospitals, and post-acute care and post discharge care. The Operational metrics would also study the infra-structure, the state of IT, web services, reporting and sharing of information among the executives and owners.

The Customer Perspective should pay close attention to physician and employee satisfaction and retention, response rates and reputation. When practices are not wholly owned, this becomes an even more serious concern for any IPA. Also, the strength and managed care savvy of affiliates and risk of losses due to poor utilization by them cannot be ignored. If the IPA does not see itself as a fiscal intermediary and does not have adequate protections against a downturn and that it is in a risk business where the Pareto rule can get easily skewed from 20-80 to 1-99 and if the reserves are not strong or re-insurance is weak, all the juggling of numbers is of scarce significance.

An IPA is not any stronger by randomly signing up affiliates without interest, aptitude or drive to master managed care; in fact, the very opposite is true. Without proper infra-structure in place, an IPA should not attempt to grow. The continuous education and training of its employees is a sine qua non with any growth and a culture of compliance, quality and excellence should be a part of its DNA. The best IPA is a Learning Organization and a Knowledge-Creating Organization.

The concept of a Poison Pill in the valuation of any IPA is of much use. If the risk to the IPA due to significant legal or regulatory liability is high, it completely negates any financial valuation of the IPA almost like a junk bond and, in fact, may give it a negative status. We see this frequently in the market place when we see how the credit agencies appraise a company or a nation. Recently, we have seen how Universal Health Care, Inc, a Medicare Advantage plan, was taken over by a receiver thereby reducing its value to zero and with significant legal and financial liability to its executives and owners, when the Office of Insurance Regulations (OIR) decided that the plan was out of compliance. An IPA may come under the purview of the OIR too in a similar fashion.

Eventually, one must remember that any metric is only a reflection of an overall strategy, vision and mission, and the core competence of an IPA. If the IPA loses sight of these, no amount of tactical quantification would suffice in making it healthy and sustainable. Strategy must be integrated completely with the processes and the core strength of the entity should never be compromised.  For if the core is forsaken, all is forsaken and the vitality of the organization may be irretrievably lost.

Jerry Hesch’s Triple Play

Jerry HeschJerry HeschJerry Hesch

Jerry Hesch is an attorney at Berger Singerman in its Miami, Florida office and is Special Tax Counsel to Oshins & Associates in Las Vegas Nevada. He is the Director of the Notre Dame Tax and Estate Planning Institute, on the Tax Management Advisory Board, a Fellow of ACTEC, has published numerous articles, Tax Management Portfolios, and co-authored a law school casebook on Federal Income Taxation, now in its fourth edition. Jerry has been kind enough to schedule the following 3 interesting events with us:

 1.   On Monday, April 14, 2014 at 12:30 pm, Jerry will join Alan Gassman to lead a discussion on his latest thinking on self-cancelling installment notes, the Kite case, private annuities, and the ins and outs of triumph spit fires.

 Join Jerry, Alan, and Jerry’s triumph spit fire for an interesting conversation.  There is no charge for this webinar and participants will receive a picture of Jerry’s car.  CPAs will receive continuing education credit.

 2.   On Thursday April 17, 2014, Jerry will speak at a donor luncheon at Ruth Eckerd Hall in Clearwater, Florida on capitalized charitable tax savings: How to make sure that Uncle Sam contributes his share to maximize results.

 Financial advisors are welcome.  The lunch will cost less than $20.  Bring a friend or even someone who you do not like.

 3.   At 4:00 p.m., Jerry will be giving a free presentation at Ruth Eckerd Hall on capitalized innovative charitable giving techniques for the well tuned estate planner, and an outline will be provided.  This session is free and qualifies for 1 hour of continuing education credit.

Please also do not forget that on April 25, 2014, Jerry will be speaking at the Ave Maria Law School Estate Planners Day on the topic of Succession Planning for the Closely Held Business Upon Retirement or Death of the Principal.

Jerry also will be speaking at the Florida Bar Annual Wealth Protection Seminar on Capitalized Income and Estate Tax Issues for 2014 – Questions and Answers at the lunch presentation from 12:15 pm to 1:00 pm.

Following that Jerry will appear at the Sands Hotel in Law Vegas, Nevada to deliver his comedy routine on Timing Income Tax Deductions and Mother-In-Law Relationships.

Free Phone Call to Improve Your Estate Planning and/or Tax Practice
For Lawyers Only
On Thursday, April 3, 2014 at 3:00pm

Business coach Rick Solomon will be teaming up with Alan Gassman and Craig Hersch to establish a small group of estate planning and tax lawyers who will meet periodically to talk about improving our practices.

If you are interested in attending a short call on the afternoon of April 3, 2014 with Rick and a few other interested lawyers, please let us know.

From Rick:

There is a very special event coming up that could potentially have a significant impact on the growth and success of your practice. It is the launch of a special Masters Program for estate planning and tax attorneys that goes far beyond basic business and office development. It goes deeply into personal development and how to address limiting beliefs and issues that all successful professionals have. This can have a significant impact on our practices.

The program is headed by me, who has created and facilitated a special Masters Programs for CPAs. I am working with Alan Gassman and Craig Hesch to develop a Masters Program for estate planning and tax lawyers. Previously I have worked extensively with the organization that evolved into Wealth Counsel many years ago, and therefore has a good feel for situations specific to a law practice.

We are only interested in working with open-minded professionals who are willing to help one another and have or wish to have a great passion for what we do, more time off, and enhanced income.

Upcoming Seminars and Webinars

COMPOUNDING THE PROBLEMS AND OPPORTUNITIES FOR COMPOUNDING PHARMACIES

Date:  Tuesday, April 1, 2014 at 5:00 p.m.

Location: Online webinar

Speakers: Lester Perling and Alan Gassman

Additional Information: Please click here to register for the webinar.

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LUNCH TALK – LAW PRACTICE EFFICIENCY TIPS

Date: Monday, April 7, 2014 | 12:30 p.m.

Location: Online webinar

Speaker: Alan S. Gassman

Additional Information: To register for this webinar please visit www.clearwaterbar.org

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LEGAL COMPLIANCE FOR MEDICAL PRACTICES THAT USE NURSE PRACTITIONERS AND PRACTICE EXTENDERS

Date: Thursday, April 10, 2014 | 5:00 p.m. (30 Minutes)

Location: Online webinar

Speakers: Cynthia Mikos, Esq. and Alan S. Gassman, Esq.

Cynthia Mikos is an excellent speaker and healthcare lawyer.  Join her fan club by attending this informative webinar.  Her materials are excellent.

Additional Information: To register for this webinar please click here.

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JERRY HESCH’S LATEST THINKING IS ON SELF-CANCELLING INSTALLMENT NOTES, THE KITE CASE, PRIVATE ANNUITIES, AND TRIUMPH SPIT-FIRES

Date: Monday, April 14, 2014 | 12:30 p.m. (30 Minutes)

Location: Online webinar

Speakers: Jerry Hesch and Alan S. Gassman

Additional Information: To register for this webinar please click here.

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FICPA SUNCOAST CHAPTER MONTHLY MEETING

Alan S. Gassman will be speaking at the FICPA Suncoast Chapter’s monthly meeting on the topic of THE FLORIDA CPA’S GUIDE TO PLANNING WITH PHYSICIANS AND MEDICAL PRACTICES

Date: Thursday, April 17, 2014 | 4:00 p.m.

Location: Tampa, Florida

Additional Information: For more information on this event please email agassman@gassmanpa.com or mary@clawsonasplus.com

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DONOR LUNCHEON AT RUTH ECKERD HALL WITH PROFESSOR JERRY HESCH IN CLEARWATER, FLORIDA

Sponsored by Gassman, Crotty & Denicolo, P.A. Co-sponsors invited.

Professor Jerry Hesch will be speaking at a Donor Luncheon on the topic of CHARITABLE TAX SAVINGS: HOW TO MAKE SURE THAT UNCLE SAM CONTRIBUTES HIS SHARE TO MAXIMIZE RESULTS

Date: Tuesday, April 22, 2014 | TIME TO BE DETERMINED

Location: Ruth Eckerd Hall, Clearwater, Florida

Additional Information: For additional information please contact Suzanne Ruley at sruley@rutheckerd.net or Alan Gassman at agassman@gassmanpa.com

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RUTH ECKERD HALL PLANNED GIVING MEETING

Professor Jerry Hesch will be speaking at the Ruth Eckerd Hall Planned Giving Meeting in Clearwater, Florida on the topic of INNOVATIVE CHARITABLE GIVING TECHNIQUES FOR THE WELL TUNED ESTATE PLANNER

Sponsored by Gassman, Crotty & Denicolo, P.A. Co-sponsors invited.

Date: Tuesday, April 22, 2014 | 4:00 p.m.

Location: Ruth Eckerd Hall, Clearwater, Florida

Additional Information: This session qualifies for 1 hour of continuing education credit for lawyers and CPA’s.  To attend please email Suzanne Ruley at sruley@rutheckerd.net or Alan Gassman at agassman@gassmanpa.com

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1st ANNUAL ESTATE PLANNER’S DAY AT AVE MARIA SCHOOL OF LAW

Speakers: Speakers will include Professor Jerry Hesch, Jonathan Gopman, Alan Gassman and others.

Alan Gassman will cover Using Estate Planning Techniques to Optimize Family Wealth Preservation.

Date: April 25, 2014

Location: Ave Maria School of Law, Naples, Florida

Sponsors: AveMariaSchool of Law, Collier County Estate Planning Council and more to be announced.

Additional Information: For more information on this event please contact visit http://www.avemarialaw.edu/estateplanning/Index.aspx

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WHAT LAWYERS AND TAX ADVISORS NEED TO KNOW WHEN PLANNING FOR SAME SEX COUPLES – UNUSUAL RULES, STRATEGIES, CHECKLISTS AND TRAPS FOR THE UNWARY

Speaker: Alan S. Gassman

Date: Monday, April 28, 2014 | 12:30 – 2:00 p.m.

Location: Bloomberg BNA Tax & Accounting Online webinar

Additional Information:  For more information, to register and a discount code please email agassman@gassmanpa.com

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THE FLORIDA BAR ANNUAL WEALTH PROTECTION SEMINAR (with 2 hours of Ethics CLE credit)

I think that we have hit the ball well out of the ballpark for the May 8, 2014 Annual Wealth Protection Seminar.

Please check out the schedule below and come and see us.

We are particularly looking forward to the ethical panel discussion that will include reviewing important components for fee agreements, conflict of interest rules, liability avoidance for professionals, and comprehensive practice checklists.

Date: Thursday, May 8, 2014

Speakers and Agenda:

8:30 a.m. B 9:00 a.m. – How I ask Questions and Obtain the Right Documents and Information to Develop a Clients Asset Protection Profile.

 Speaker: Denis Kleinfeld, Esq.

 9:00 a.m. B 9:40 a.m. – How I Structure an Integrated Income, Estate Tax, and Asset Protection Family Plan.

 Speaker: Alan S. Gassman, Esq.

 9:40 a.m. B 10:30 a.m. – The New Designer Entities B How to Use These Cutting Edge Tools to Protect Wealth.

 Speaker: Howard Fisher, Esq. and Alex Fisher, Esq.

 10:30 a.m. B 10:45 a.m.  Break (Mingle and Exchange Cards)

10:45 a.m. B 11:30 a.m. – What the Last Two Years of Legal Developments and Litigation Tells Us About Protective Planning With Trust and Associated Entities

 Speaker: Barry Engel, Esq.

 11:30 a.m. B 12:15 p.m. – What The Case Law Tells Me About Charging Orders and Declaratory Judgments.

 Speaker: Jay Adkisson, Esq.

12:15 p.m. B 1:00 p.m. Lunch (Box Lunch) – Income and Estate Tax Issues For 2014 B Q & A.

 Speaker: Jerry Hesch, Esq.

 1:00 p.m. B 2:30 p.m. – What We Think You Need to Know About Asset Protection Litigation and Obtaining A Good Result For the Client.

 Speakers: Jay Adkisson, Howard Fisher, Alex Fisher and Denis Kleinfeld.

 2:30 p.m. B 2:45 p.m.  Break

2:45 p.m. B 4:15 p.m. – What are the Ethical, Legal and Administrative Liability Exposures in Wealth Protection Planning and How Do We Protect Ourselves.

 Speakers: Barry Engel, Alan Gassman, Jerry Hesch, and Denis Kleinfeld.

 4:15 p.m. B 5:00 p.m. – Open Forum Q & A

 Speakers: Barry Engel, Jay Adkisson, Howard Fisher, Jerry Hesch, Alan Gassman and Denis Kleinfeld.

Location: Hyatt Regency Downtown, Miami, Florida

Additional Information: For more information please contact agassman@gassmanpa.com

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THE JOINT EXEMPT STEP-UP TRUST

Alan Gassman will be speaking at the Ohio Conference on Wealth Transfer on The Joint Exempt Step-Up Trust as well as participating in a panel discussion the evening before.

Date: June 4, 2014

Location: Hilton at Easton, Columbus, Ohio

Additional Information:  For more information on the conference and to register for the conference please contact agassman@gassmanpa.com

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HIRING AND TERMINATING EMPLOYEES; WHAT TO DO, WHAT TO AVOID

Speaker: Colleen Flynn, Esq., Dr. Stephanie Thomason and Alan S. Gassman, Esq.

Date: Wednesday, June 18, 2014 | 2:00 – 3:00 p.m.

Location: Bloomberg BNA Tax & Accounting Online webinar

Additional Information:  For more information, to register and a discount code please email agassman@gassmanpa.com

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40th ANNUAL NOTRE DAME TAX & ESTATE PLANNING INSTITUTE

Please send us your questions, comments and suggestions for Alan Gassman’s talk on Planning with Variable Annuities.  He will also discuss how to spreadsheet and illustrate how life insurance policies and mutual funds work in the taxable and non-taxable world, and how to evaluate whether real savings occur from tax deferral.

Date: November 13 and 14, 2014

Location: Century Center, South Bend, Indiana

We welcome questions, comments and suggestions on variable annuities, which will be Alan Gassman’s topic for this conference.

Additional Information: The focus of this year’s institute will be on “Business Succession Planning: An Income Tax, Estate Tax and Financial Analysis.”  As in past years, several sessions are designed to evaluate certain financial products and tax planning techniques so that the audience can better understand and evaluate these proposals in determining not only the tax and financial advantages they offer, but also evaluate limitations and problems they may cause in the future.  Given that fewer clients will need high-end estate tax planning with the $5 million exemptions, other sessions will address concerns that all clients have.  For example, a session will describe scams that target elderly individuals and how to protect the elderly from these scams.  As part of the objective on refreshing or introducing the audience to areas that can expand their practice, other sessions will review the income tax consequences of debt cancellation, foreclosures, short sales, the special concerns that arise in bankruptcy and various planning available to eliminate the cancellation of debt income or at least defer it with a possible step-up basis at death.  The Institute will also continue to have sessions devoted to income tax planning techniques that clients can use immediately instead of waiting to save estate taxes far in the future.

Past Seminar and Webinar Transcripts Available

For a transcript of Mr. Gassman’s remarks for the following, please email agassman@gassmanpa.com.

  • The Florida Bar Leadership Academy: March 2014 Regional Meeting

Alan Gassman joined Judge Claudia Rickert Isom and Hillsborough County Bar Association President Susan E. Johnson-Valez for a panel discussion on the Benefits of Serving as a Community Leader.

Applicable Federal Rates

Below we have this month, last month’s, and the preceding month’s Applicable Federal Rates, because for a sale you can use the lowest of the 3.

APR