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MTEL - Massachusetts Tests for Educator Licensure - BrainDump Information

Vendor Name : Certification-Board
Exam Code : MTEL
Exam Name : Massachusetts Tests for Educator Licensure
Questions and Answers : 457 Q & A
Updated On : November 16, 2018
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MTEL exam Dumps Source : Massachusetts Tests for Educator Licensure

Test Code : MTEL
Test Name : Massachusetts Tests for Educator Licensure
Vendor Name : Certification-Board
Q&A : 457 Real Questions

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Certification-Board Certification-Board Massachusetts Tests for

CMS concerns closing Medicare PFS Rule for CY 2019 | killexams.com Real Questions and Pass4sure dumps

On November 1, 2018, the centers for Medicare and Medicaid functions (CMS) launched in pre-publication form the Medicare surgeon fee schedule (PFS) ultimate Rule for Calendar yr (CY) 2019 (PFS last Rule) . The PFS closing Rule includes a few significant adjustments, together with:

• featuring for reimbursement for conversation expertise-based services and expanding access to telehealth functions with the aid of enabling for compensation for acute stroke telehealth functions;• streamlining necessities for contrast and management (E/M) visits to reduce administrative and regulatory burden associated with documentation of the visits and changing payment guidelines to create a single charge price for stages 2 through 4 visits;• establishing a payment methodology for the customary care administration features for Rural fitness facilities (RHCs) and Federally qualified health facilities (FQHCs); • aligning the digital clinical quality measures (eCQMs) available for Medicaid Eligible specialists (EPs) in 2019 with these purchasable for merit-based Incentive payment device (MIPS) eligible clinicians for the CY 2019 performance period; • imposing amendments to the Stark law rules according to statutory alterations regarding the writing and signature requirements;• updating the CMS great payment application (QPP); andchanging the definition of “applicable laboratories” for applications of the suggestions requiring reporting of deepest payor rates.

We give under a full abstract of each of the important thing adjustments mentioned above and supply other highlights from the PFS closing Rule. The PFS final Rule is scheduled to be published in the Federal Register on November 23, 2018. A hyperlink to our prior alert on the PFS Proposed Rule is provided right here.

Modernizing Medicare health practitioner payment by Recognizing communication know-how-based mostly capabilities CMS finalized its proposals to set up new payment codes to reimburse clinicians for certain know-how-based functions below particular conditions, together with:

• Healthcare ordinary process Coding gadget (HCPCS) code G2012, for quick verbal exchange technology-primarily based services, similar to quick non-face-to-face virtual assess-ins that take place by means of telecommunications technology (together with audio-best communications) if certain necessities are met;• HCPCS code G2010 to make separate payment for faraway comparison of recorded video and/or photographs submitted via a longtime patient; and• separate payment for interprofessional session CPT codes 99451, 99452, 99446, 99447, 99448, and 99449, which describe evaluation and management services conducted via telephone, web, or digital health record consultations furnished when a affected person’s treating general practitioner or other qualified health professional requests the opinion and/or remedy counsel of a consulting doctor or qualified health practitioner with particular area of expertise talents to assist with the prognosis and/or management of the patient’s problem with out the want for the patient’s face-to-face contact with the consulting healthcare professional or certified doctor.

CMS particularly emphasised the magnitude of notifying patients of their charge-sharing tasks concerning these far off capabilities (which CMS cited it does not have the authority to waive), despite any abilities burden on clinicians. consequently, clinicians must attain patient consent, which must be documented in the clinical listing, each time such far flung functions are supplied.

moreover, with the intention to put into effect the requirements of part 50325 of the Bipartisan finances Act of 2018, CMS finalized a brand new modifier to identify acute stroke telehealth functions and revisions to 42 C.F.R. § 410.78 and § 414.sixty five to permit for repayment for acute stroke telehealth services, including a definition of “cellular stroke unit” and the addition of a cellular stroke unit as a permissible originating web site for such acute stroke telehealth capabilities .

intervening time final Rule increasing the use of Telehealth services for the remedy of Opioid Use sickness and different Substance Use disorders under the Substance Use-disease Prevention that Promotes Opioid restoration and remedy for sufferers and Communities Act part 2001(a) of the Substance Use-disorder Prevention that Promotes Opioid recuperation and treatment for sufferers and Communities Act (guide Act) amended area 1834(m) of the Social protection Act to get rid of the originating website geographic necessities for telehealth features furnished on or after July 1, 2019, for the goal of treating people clinically determined with a substance use disease or a co-occurring intellectual fitness disease (apart from a renal dialysis facility), add someone’s domestic as a permissible originating website for these telehealth capabilities, and require that no originating website facility payment be paid in cases when the particular person’s house is the originating website. additionally, section 2005 of the guide Act establishes a brand new Medicare benefit category for opioid use sickness remedy features furnished by using Opioid remedy programs (OTPs) under Medicare part B, beginning on or after January 1, 2020, which requires that opioid use ailment medication functions consist of meals and Drug Administration (FDA) authorized opioid agonist and antagonist remedy medications, the doling out and administration of such medicines (if relevant), substance use disease counseling, individual and neighborhood remedy, toxicology trying out, and different services determined appropriate (but no longer nutrients and transportation). area 2005 defines OTPs as people who subscribe to Medicare and are licensed by way of the Substance Abuse and mental health capabilities Administration (SAMHSA), accredited with the aid of a SAMHSA-approved entity, and meeting further situations as the Secretary finds crucial to be sure the fitness and safety of people being furnished functions below these courses and the useful and efficient furnishing of such features. 

in order to enforce the requirements of section 2001(a) of the help Act, CMS has issued an meantime remaining rule with remark period revising several Medicare telehealth regulations. there's a 60-day period following ebook of the interim remaining rule for the public to touch upon these interim last amendments to the regulations and to reply to CMS’s request for counsel concerning features furnished with the aid of OTPs, funds for these features, and extra situations for Medicare participation for OTPs that stakeholders agree with can be valuable to accept as true with for future rulemaking to enforce this new Medicare benefit class. additionally, CMS is requesting as part of this interim remaining rule more information from stakeholders and the general public that might be regarded for future rulemaking involving charge constitution and quantities for substance abuse disease (SUD) remedy that account for ongoing medication and large variability in patient wants for remedy of SUDs whereas enhancing access to crucial care. 

fee prices under the Medicare PFS for Nonexcepted objects and functions Furnished via Nonexcepted Off-Campus issuer-primarily based Departments of a health facility within the PFS last Rule, CMS finalized its concept to proceed the CY 2018 payment mechanism and repayment amounts for nonexcepted off-campus clinic outpatient issuer-primarily based departments (PBDs). In certain, CMS will proceed to enable nonexcepted off-campus PBDs to bill for nonexcepted objects and functions on institutional claims with a “PN” modifier, which will be used “unless we identify a workable option mechanism to enrich charge accuracy.”  CMS will additionally proceed to pay with the PFS repayment amount for such functions set at forty% of OPPS — i.e., the PFS Relativity Adjuster. In calculating this PFS Relativity Adjuster, CMS mentioned that its evaluation supports maintaining an adjustment of 40% for CY 2019 and past “until there is an acceptable rationale and technique for imposing a substitute for our policy.” In environment the price, CMS rejected the arguments of commenters who wrote that a rate of 65–70% can be extra applicable. 

evaluation and management Visits CMS finalized a number of alterations to E/M consult with documentation and price instructions, that allows you to observe primarily to office-primarily based and outpatient consult with codes.  These adjustments are part of CMS’s ongoing effort to in the reduction of the regulatory burden associated with E/M coding and charge. 

Documentation CMS’s E/M Documentation instructions set forth the clinical assistance required to aid an E/M seek advice from in three classes: background of existing disorder, physical examination, and scientific resolution-making. Practitioners currently may choose to use one in all two types of the E/M Documentation instructions, the “1995” or the “1997” instructions, to aid a stage 1 via 5 E/M seek advice from. with the intention to in the reduction of administrative burden, CMS finalized new documentation options to promote flexibility involving the documentation required for E/M visits. positive January 1, 2021, practitioners could be in a position to select among the many following documentation methodologies to help E/M stage 2 through four visits:

1) the existing “1995” or “1997” E/M Documentation guidelines, enough to help a stage 2 E/M discuss with;2) the scientific choice-making component of an E/M talk over with on my own, ample to guide a stage 2 E/M visit under the 1995 or 1997 E/M Documentation instructions; or three) the total quantity of face-to-face time or length of an E/M discuss with on my own, documenting that the practitioner personally spent the existing normal time associated with the CPT code stated on the declare. 

Simplified charge amounts in the PFS Proposed Rule, CMS proposed to pay a single cost for degree 2 via level 5 E/M visits via constructing sets of relative cost units (RVUs) below the PFS for brand new sufferers and latest sufferers. CMS obtained comments that the proposed single payment rate would now not appropriately account for the quantity of supplies required to treat essentially the most complicated patients.  In response, CMS in its place finalized a single price cost for E/M talk over with tiers 2 through 4, establishing a group of RVUs under the PFS for E/M visit ranges 2 via four for brand spanking new sufferers (CPT codes 99202 via 99204) and a collection of RVUs for E/M visit levels 2 through 4 for existing sufferers (CPT codes 99212 through 99214).  CMS will hold separate price quotes for brand new and based patients for E/M ranges 1 and 5 visits.  additionally, in response to commenters’ issues involving the timing of such change, CMS delayed the advantageous date of the single price price for degrees 2 through 4 E/M visits, in an effort to no longer turn into advantageous until January 1, 2021. 

Corresponding charge alterations in addition to finalizing a single fee price for talk over with ranges 2 via four, CMS additionally accounted for resource charges associated with certain E/M level 2 via 4 visits requiring different types of care by finalizing two corresponding charge policies and changes:

• HCPCS codes GCG0X and GPC1X, for talk over with complexity inherent to E/M features associated with basic care and non-procedural distinctiveness care (e.g., endocrinology, rheumatology, and so forth.), respectively. • HCPCS code GPRO1, for extended time for E/M services, when the seek advice from requires direct affected person contact of 34-sixty nine face-to-face minutes standard for existing sufferers or 38-89 face-to-face minutes normal for brand spanking new patients. 

These payment alterations will also become constructive January 1, 2021. [23]

instructing medical professional Documentation requirements for assessment and administration services CMS finalized changes to the documentation required for price for teaching surgeon functions beneath the PFS.  presently, a instructing surgeon’s participation in the assessment and route of E/M features performed by a resident must be individually documented by using the educating health care provider. with the intention to in the reduction of burden and duplication of effort for instructing physicians,  CMS finalized adjustments such that the participation of the instructing health practitioner all the way through E/M functions needn't be one at a time documented with the aid of the teaching healthcare professional, however may be validated by way of the notes in the medical statistics made by means of a doctor, resident, or nurse.  This documentation requirement will turn into valuable January 1, 2019. 

remedy capabilities Outpatient remedy services (physical remedy and occupational therapy) furnished in complete or partly via a therapy assistant may be reimbursed at a cost of 85% of the otherwise applicable part B fee amount for the carrier. This decreased charge quantity for outpatient remedy functions is applicable when price is made without delay under the PFS. To enforce this provision, CMS proposed to establish two new modifiers to determine separate actual therapy and occupational remedy capabilities that are furnished in total or partly by means of a therapy assistant. rather than organising these modifiers as new remedy modifiers, as proposed, CMS opted to establish the two new modifiers as charge modifiers to be used in conjunction with present therapy modifiers to be able to reduce the executive burden on actual therapy and occupational therapy gurus linked to the addition of recent therapy modifiers.  in the PFS closing Rule, CMS additionally changed its proposed definition of a service that is furnished in total or partially by using a therapy assistant to create a de minimis commonplace below which a provider is furnished in whole or partially with the aid of a therapy assistant when more than 10% of the carrier is furnished via a remedy assistant. 

additionally, CMS indicated that the everyday consensus of commenters who replied to CMS’s Request for assistance on burden discounts changed into that the practical reporting requirements for outpatient remedy features are overly complicated and burdensome.  based on the feedback, CMS finalized its inspiration to discontinue the useful reporting requirements for outpatient remedy capabilities furnished on or after January 1, 2019. 

half B drugs: utility of an Add-on percent for certain Wholesale Acquisition charge (WAC)-based payments CMS finalized its thought to make use of a 3% add-on in place of the present 6% add-on for payments for part B medication in accordance with wholesale acquisition charge (WAC) made below section 1847A(c)(four) of the Social protection Act. In so doing, CMS indicated that the exchange would cut back the economic incentive below the present system to over utilize new medicine and would no longer tremendously affect providers via reduced margins for half B medicine. 

expertise model for Radiation remedy The affected person access and Medicare protection Act,  enacted December 28, 2015 (PAMPA), required CMS, in 2017 and 2018, to follow the same code definitions and work RVUs for the fee agenda dependent beneath part 1848(b) of the Act and section 1848(c)(2)(C)(ii) of the Act, and to practice the equal direct inputs for the PE RVUs for radiation medication beginning and related imaging functions under section 1848(c)(2)(C)(ii) of the Act as these definitions, contraptions, and inputs for such functions for the charge schedule based for functions furnished in 2016. PAMPA also required the Secretary of health and Human services (HHS) to submit a record to Congress on the building of an episodic advanced fee mannequin for Medicare fee for radiation therapy capabilities furnished in non-facility settings. HHS delivered this record to Congress in November 2017. CMS mentioned that “episode payment fashions will also be a tool for making improvements to care and decreasing bills” and additional indicated that CMS believes that “radiation oncology is a promising area of health look after bundled payments.” The PFS last Rule states that the CMS Innovation center will proceed to make use of stakeholder comments and public information involving business initiatives to support inform the development, implementation, and refinement of design and trying out of a possible mannequin that tests price for radiation therapy functions. 

scientific Laboratory payment agenda CMS carried out revisions to the medical Laboratory price agenda (CLFS) in response to part 216 of the conserving entry to Medicare Act of 2014 (PAMA), which required that the payment volume for many clinical diagnostic laboratory tests (CDLTs) be equal to the weighted median of inner most payor charges. Pursuant to regulations promulgated through CMS at forty two C.F.R. § 414.500 et seq., an entity ought to record inner most payor costs, volume information, and other “applicable counsel” for each and every CDLT furnished via each and every of its add-ons that meets the definition of an “applicable laboratory” each three years.  the first circular of reporting turned into required within the first a part of 2017, and became used by using CMS to set charges below the CLFS beginning January 1, 2018. 

As presently defined, the term “relevant laboratory” ability an entity it truly is a laboratory, as defined within the clinical Laboratory development Amendments (CLIA) laws; bills Medicare part B below its own country wide company Identifier (NPI); and, in the applicable six-month statistics collection duration, meets each the “majority of Medicare revenues threshold” and the “low expenditure threshold.”  the majority of Medicare revenues threshold is met if the entity receives, under its NPI, greater than 50% of its Medicare revenues through price below the CLFS (42 C.F.R. half 414, subpart G) and/or the PFS (forty two C.F.R. part 414, subpart B). The low expenditure threshold is met if the entity receives, below its NPI, at the least $12,500 of its Medicare revenues from the CLFS for CDLTs that aren't superior diagnostic laboratory exams. 

in accordance with stakeholder comments noting that the 2018 CLFS fee quotes have been according to information collected from a relatively small variety of applicable laboratories and, for this reason, arguing that the rates were inaccurate, CMS finalized its concept to trade the calculation of the vast majority of Medicare revenues threshold through except funds made by using Medicare advantage (MA) plans below Medicare part C from the denominator.  CMS continues that this alternate will permit laboratories that have massive revenues from MA funds to qualify as relevant laboratories, thereby expanding the amount of mentioned statistics used to investigate CLFS price costs. 

As referred to above, an applicable laboratory is at the moment defined, partly, as an entity that bills under its personal NPI. despite the fact, many health facility outreach laboratories invoice below the NPI of the hospital, in preference to their own NPI. for that reason, with a purpose to include a more desirable variety of medical institution outreach laboratories below the definition of an applicable laboratory, CMS finalized an strategy, whereby clinic outreach laboratories will determine whether or not they meet the requirements to be considered an “relevant laboratory” using most effective revenues for features mentioned under bill type 14x on the form CMS-1450, which is used for health facility laboratory services offered to non-patients, as opposed to using all Medicare revenues reported below the NPI used on the expenses.  within the proposed rule, CMS expressed its concerns that this strategy would latest operational issues for hospitals as well as potentially be inconsistent with statutory authority, based mostly in part on CMS’s view that this trade would result in all medical institution outreach laboratories meeting the definition of applicable laboratories. however, after receiving stakeholder commentary on the concern, CMS reasoned that this exchange will not impermissibly trigger all health center outreach laboratories to fulfill the definition of relevant laboratories as a result of, with the intention to meet that definition, the $12,500.00 low expenditure threshold nevertheless ought to be met. 

eventually, as mentioned in better detail in our prior alert, in the Proposed Rule, CMS requested feedback on a notion to trade the low expenditure threshold, and a concept to use CLIA certificates to define relevant laboratories. within the remaining Rule, CMS recounted stakeholder feedback, however declined to finalize changes imposing either idea. 

fee for Care management capabilities and communique know-how-based features in Rural health Clinics (RHCs) and Federally certified health facilities (FQHCs) For Rural health centers (RHCs) and Federally certified fitness facilities (FQHCs), CMS finalized the proposed price methodology for the standard care management functions HCPCS code G0511, because the standard of the national non-facility PFS fee expense for certain CPT codes. CMS also finalized its inspiration to set up a separate price to RHCs and FQHCs for HCPCS code G0071 (digital conversation functions), which represents as a minimum five minutes of communique technology-based mostly features or remote comparison features now not at present captured in the RHC all-inclusive fee or the FQHC potential charge techniques when the requirements for such features are met. 

acceptable Use criteria for advanced Diagnostic Imaging functions CMS finalized lots of its proposals involving appropriate use standards (AUC) for superior diagnostic imaging capabilities as originally proposed. at the beginning dependent in the CY 2016 remaining rule, practitioners should be required to check with proof‐primarily based AUC when ordering and furnishing applicable imaging functions to exploit appropriate treatment selections for selected medical circumstances starting in 2020. These proposals are seeking to provide further clarification to AUC requirements that, whereas currently voluntary, can be required for suppliers valuable January 1, 2020. The PFS final Rule clarifies the following:

• unbiased diagnostic checking out facilities are applicable settings which require AUC session and reporting, as originally proposed;  • when not individually carried out through the ordering professional, AUC session may well be delegated to and performed by using scientific body of workers working under the direction of the ordering expert, as modified from the initial inspiration that “auxiliary personnel” can also function the AUC consultation “incident to” the ordering skilled’s services; • AUC session must be mentioned on all claims for relevant imaging capabilities, together with both the skilled and facility claims, as originally proposed; • providers can also report AUC assistance on claims using established coding strategies, together with definite G-codes and modifiers, as at the start proposed; although, CMS mentioned advantage technical concerns concerning this strategy and brought up that it will continue to address such issues all over implementation;  and• alterations to the huge trouble exception that include insufficient internet entry, electronic fitness checklist (EHR) or scientific choice guide mechanism seller considerations, or excessive and uncontrollable instances, as firstly proposed. 

finally, CMS cited its intention to handle outlier identification and prior authorization more entirely in future CY 2022 or 2023 rulemaking. 

Medicaid merchandising Interoperability program necessities for Eligible authorities CMS finalized devoid of alternate its thought to amend the list of accessible eCQMs for the CY 2019 efficiency period.  through these alterations, CMS aligns the eCQMs available for Medicaid Eligible specialists (EPs) in 2019 with these obtainable for merit-primarily based Incentive price gadget (MIPS) eligible clinicians for the CY 2019 performance length, in order that the eCQMs available for Medicaid EPs in 2019 consist of the great measures available under the eCQM assortment type on the last checklist of excellent measures based under MIPS for the CY 2019 efficiency length. 

CMS also finalized its proposal for CY 2019 that requires Medicaid EPs to document on any six eCQMs that are significant to the EP’s scope of follow, both by way of attestation or electronically. additionally, CMS finalized its concept that EPs record on as a minimum one outcomes measure (or, if an applicable result measure is not accessible or crucial, one different high-precedence measure).  CMS explains within the PFS final Rule that, if no effect or high-precedence measure is relevant to a Medicaid EP’s scope of observe, the EP may additionally report on any six eCQMs central to his or her follow. 

furthermore, CMS finalized its notion to enable states to point out which eCQMs are excessive-priority measures for that state’s Medicaid company. CMS reiterates that, if no effect or precedence measure is critical to the Medicaid EP’s scope of observe, he or she may additionally report on six crucial measures. 

CMS finalized its notion that the eCQM reporting length for EPs in the Medicaid promotion Interoperability program should be a full CY in 2019 for EPs that have tested meaningful use in a previous year, to be able to align with the corresponding efficiency length in MIPS for the nice performance class.  CMS additionally finalized the EHR reporting period in 2021 for all EPs within the Medicaid promotion Interoperability program at the least of any continual ninety-day length inside CY 2021, provided that the conclusion date for this period falls before October 31, 2021. 

finally, for Measure 1 (View, down load, or Transmit) and Measure 2 (secure digital Messaging) of meaningful Use Stage 3 EP aim 6 (Coordination of Care via patient Engagement), CMS finalized its alternate to the thresholds so that they'll continue to be at 5% for 2019 and subsequent years. 

healthcare professional Self-Referral law & Annual replace to the record of CPT/HCPCS Codes in order to align the Stark legislation regulations with Stark law statutory amendments enacted as a part of the Bipartisan finances Act of 2018, CMS had proposed amendments to current necessities for a written settlement and signature necessities.

• Written settlement: CMS proposed a new special rule on compensation preparations at forty two C.F.R. § 411.354(e) to explicitly enable that, for any compensation arrangement it really is required to be in writing, the writing requirement can be convinced by way of a collection of documents, together with contemporaneous documents evidencing the direction of conduct between the events. CMS received a couple of feedback in assist of its inspiration to codify its present coverage on the writing requirement, and received no comments opposing its concept. CMS finalized the proposed § 411.354(e) with out change. • Signature requirements: CMS additionally proposed changes to the regulatory provision involving temporary noncompliance with signature requirements at forty two C.F.R. § 411.353(g)(1) to provide that parties have 90 days to attain signatures no matter if the lack of a well timed signature became advertent or inadvertent, and deletion of the latest restriction that the temporary compliance rule may best be used once every three years for a specific healthcare professional or health care provider group. within the alternative, CMS proposed deleting the regulatory part 42 C.F.R. § 411.353(g) in its entirety, which set out the special rules for arrangements involving transient noncompliance with the signature requirement, and instead codifying the statutory language setting forth the special rule for signature requirements. CMS got a number of comments expressing usual support for the particular rule on temporary noncompliance with signature requirements, and no comments opposing the suggestion.  CMS stated that it should be less disruptive to amend the existing legislation at § 411.353(g), in preference to delete the part in its entirety and codify the statutory language in a brand new regulatory area. As such, CMS finalized its thought to revise the particular rule for temporary noncompliance with signature necessities at § 411.353(g), thus aligning § 411.353(g) with the newly delivered statutory provision. ultimately, CMS notes that the effective date of the relevant Bipartisan funds Act area turned into February 9, 2018, and as such, starting on that date, parties who met the necessities of the statutory provision involving noncompliance with signature necessities, however otherwise would had been barred from relying on the particular rule for definite preparations involving transient noncompliance with signature necessities on account of the three-yr trouble, may also avail themselves of the brand new statutory provision of that date. • Annual replace to the Code checklist: CMS additionally posted the annual record of the additions and deletions to the comprehensive checklist of CPT codes considered DHS for functions of four classes of DHS: (1) clinical laboratory functions; (2) physical remedy, occupational remedy, and outpatient speech-language pathology capabilities; (3) radiology and likely different imaging capabilities; and (four) radiation therapy services and substances. The up-to-date Code record becomes valuable January 1, 2019. 

CY 2019 Updates to the pleasant payment software The PFS final Rule makes a significant variety of operational changes to the quality fee application (QPP), as QPP enters its third transitional yr. These adjustments cover a large choice of issues impacting both the benefit-based mostly Incentive price gadget (MIPS) and the superior option charge mannequin software (advanced APM). nearly all of the updates added within the Proposed Rule had been finalized devoid of change.

A future client alert will talk about these QPP adjustments in-depth. although, some key finalized provisions consist of the following:

• increasing the definition of a “MIPS eligible clinician” to add a few additional clinician-kinds, equivalent to actual and occupational therapists;  • revising the MIPS final ranking performance category weights; • altering the methodology for calculating the small observe efficiency bonus beneath MIPS;  • a number of changes to the these days added facility-primarily based measurement alternative under MIPS, together with including on-campus outpatient hospitals (POS-code 22) to the checklist of website of functions that CMS will use to determine eligibility for facility-based mostly dimension; • increasing the “performance threshold” (the point at which a clinician will now not incur a fee discount beneath MIPS) from 15 to 30 features out of a complete of a hundred for MIPS price year 2021.  furthermore, CMS is setting the “additional performance threshold” (the factor at which a clinician is eligible for sharing in $500,000,000 of extra incentive funding) at seventy five facets for MIPS price year 2021, a bit of under the 80 elements at the start proposed;  and• increasing the certified EHR technology (CEHRT) threshold for an APM to qualify as an superior APM, via requiring at the least 75% of eligible clinicians participating in an advanced APM to make use of CEHRT beginning in calendar yr 2019, up from the present threshold of fifty%. 

Medicare Shared rate reductions software; responsible Care companies—Pathways to Success The PFS remaining Rule additionally includes a couple of provisions related to updating Medicare Shared reductions software (MSSP) rules.  These adjustments encompass finalizing proposals added within the PFS Proposed Rule, in addition to finalizing some of the proposals brought in the fresh “Pathway to Success” proposed rule concerning MSSP. a couple of the proposed alterations from the Pathway to Success proposed rule are not addressed within the PFS final Rule, however, and may be addressed in future rulemaking, together with the proposed restructuring of MSSP software design. A abstract of the MSSP changes contained within the PFS ultimate Rule might be the subject of a future client alert.

Radiologist Assistants in accordance with 42 C.F.R. § 410.32(b), except an exception applies, all diagnostic X-ray and different diagnostic checks are required to be offered under the level of physician supervision precise through CMS, either common, direct, or very own, as those phrases are described in the rules. for most diagnostic imaging approaches, the mandatory doctor supervision degree applies only to the technical part of the method. CMS finalized its suggestion to amend § 410.32(b) such that any diagnostic assessments that could in any other case require personal supervision will now handiest require direct supervision when carried out via a registered radiologist assistant (RRA) who is certified and registered by using the American Registry of Radiologic Technologists or a radiology practitioner assistant (RPA) who is certified by using the Certification Board for Radiology Practitioner Assistants, as accepted via state legislations and state scope of observe laws. Diagnostic imaging tests requiring a popular level of health practitioner supervision still only require ordinary supervision. 

Conclusion As underscored during this alert, the alterations applied in the PFS last Rule are big and large ranging in their scope.

suppliers will should immediately verify both the functional compliance features of implementing the alterations identified within the PFS remaining Rule and the financial affect of those adjustments on their budgets.


New certified Irrigation Contractor exam to Debut at 2018 Irrigation demonstrate | killexams.com Real Questions and Pass4sure dumps

FAIRFAX, Va., Oct. 4, 2018 /PRNewswire-PRWeb/ -- The Irrigation association Certification Board has updated the exam content define for the landscape licensed irrigation contractor exam, and the revised exam will launch throughout the 2018 Irrigation reveal and education conference in long seashore, California, Dec. 3-7.

panorama experts who turn into licensed irrigation contractors are experienced enterprise owners who execute irrigation projects to installation, preserve and restoration irrigation methods. This new CIC exam content material define turned into developed because of a job project evaluation finalized in June 2018. whereas the examination domains have remained the equal, the subdomains have multiplied. extra information is purchasable in the Job analysis government summary posted on the IA web site (https://www.irrigation.org/CIC).

The IA Certification Board will introduce new objects for beta testing on a brand new variety of the one hundred fifty-question CIC examination. the new gadgets are not scored and this may not statistically alter the first-rate of the exam. folks that pass the examination will turn into licensed irrigation contractors.

"This up-to-date exam displays the IA Certification Board's efforts to hold IA certification checks fresh and principal to the altering industry," observed IA CEO Deborah Hamlin, CAE, FASAE. "The IA conducts job analyses to ensure that its certification checks are legally defensible and in keeping with what individuals inside the occupation do in the container and how they follow their advantage."

The IA Certification Board is an unbiased board that governs the IA certification application. Board contributors work intently with volunteers, trade field-count number consultants and IA personnel related to essential facets of the certification software. ultimate summer time, the Certification Board held a strategic planning session and proceed their dedication to the board's mission to advertise irrigation knowledge through certification.

The Certification Candidate instruction manual has also been up to date with a brand new specification sheet and content define for the CIC exam. additional look at references for this examination may also be discovered online (https://www.irrigation.org/CIC).

people attracted to taking the CIC exam or an additional IA certification exam throughout the Irrigation show can discuss with https://www.irrigationshow.org for extra counsel, examination schedules and to register. Taking an examination at the show requires enhance registration and a separate fee; registration is required through Nov. 18.

about the Irrigation affiliation

The Irrigation association is the leading membership company for irrigation businesses and professionals. The IA is dedicated to merchandising productive irrigation and to long-time period sustainability of water components for future generations. The IA works to increase trade talent, advocate sound water administration and develop demand for water-effective products and functions. For extra advice, talk over with https://www.irrigation.org.

 

source Irrigation affiliation


Digital Forensics Certification Board offers New Certification | killexams.com Real Questions and Pass4sure dumps

EL DORADO HILLS, CA--(Marketwired - Aug 26, 2014) - The Digital Forensics Certification Board (DFCB), an unbiased certifications organization for digital evidence examiners, nowadays introduced the creation of the Digital Forensics certified affiliate (DFCA).

The simple aim of the DFCA certification is to deliver an business neutral certification for two organizations of people. the primary community includes individuals who are new to the industry. These people are either faculty graduates within the computer forensics field or individuals who're making a career exchange and are getting into the desktop forensics box. The 2d community is for individuals who in the past served as practitioners within the business but because of changes in their job or profession they now not actively follow in the desktop forensic business on an everyday groundwork. For these two corporations, the DFCA suggests that they have got the talents to become a practitioner within the trade.

people need to finished a heritage check. Upon a success completion of the examine, a candidate will then sit down for a one hundred question exam. The examination will check the candidate in 5 areas: legal concepts, desktop forensic ethics, electronic storage media, mobile and embedded contraptions, and community forensics.

"The DFCA certification is our option to admire individuals who are only starting out in the business or are looking to continue their involvement in the trade despite changes in their career," noted Warren Kruse, President of the DFCB. "These people are the practitioners of the day before today and the practitioners of the next day and are excited to proceed, or birth out, in the world of laptop forensics."

individuals attracted to the DFCA certification should still discuss with the DFCB website at www.dfcb.org. 

about the DFCB The Digital Forensics Certification Board is a member-driven, non-earnings, dealer-impartial corporation of the international affiliation of fiscal Crimes Investigators, subsidized in part via a grant from the country wide Institute of Justice. DFCB become founded to provide, amongst other issues, an goal certification in digital forensics in an effort to promote have faith and self assurance in the digital forensics profession. visit www.dfcb.org or name 916.939.5000.




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Massachusetts Tests for Educator Licensure

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Get ready for your upcoming MTEL exam(s) with our comprehensive online test preparation courses. Our collection of MTEL video courses, practice tests and supplemental studying resources are designed to get you fully prepared for these Massachusetts teacher certification tests.

About MTEL Exams

Massachusetts Tests for Educator Licensure (MTEL) exams are used for teacher certification purposes in the state of Massachusetts. The exams, which are administered by Pearson Education, Inc., are available for aspiring PreK-12, vocational and adult education teachers. The exams cover many academic subjects, including biology, business, English, math, music, physical education and speech. MTEL exams are designed to evaluate candidates on the types of literacy, communication and academic skills that are needed in order to teach professionally in the state.

Licensure requirements for PreK-12 educators involve passing the MTEL Communication and Literacy Assessment plus subject-specific assessments based on the candidate's desired areas of specialization. Those who are pursuing a Preliminary Vocational Technical license must pass a written and performance subject matter test, plus either the Vocational Technical Literacy Test or the Communication and Literacy Skills test. Provisional and Professional Adult Basic Education licenses require candidates to pass the Communication and Literacy Skills test and the Adult Basic Education subject matter test. Be sure to check with the official MTEL website for additional licensing requirements pertaining your professional goals.

MTEL tests generally consist of multiple-choice questions and open-response assignents. Most exams are 4 hours long, and they contain around 100 multiple-choice questions and 2 open-response assignments each. MTEL exams are available throughout the year, and scores range between 100 and 300. In most cases, the passing score for an MTEL assessment is 240. You can register for your exams on the official MTEL website, and following your exam date, you'll be able to receive your scores by mail, email or via download from your MTEL account.

To start getting ready for an MTEL exam, check out our available MTEL test preparation courses:

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MTEL exams can cover a lot of information, which is why we've crafted our test preparation courses with simplicity and flexibility in mind. The courses go over the types of academic and instructional concepts that you'll encounter on your exam, and our MTEL lessons are all taught by subject matter experts. Inside each course, you'll find bite-sized video lessons, transcripts and multiple-choice quizzes. As you work through a course, use the dashboard feature to navigate to the chapter topics you want to study. Then, you can watch each video lesson and follow along with the accompanying transcripts. When you're finished with a lesson, take the accompanying quiz to make sure you fully understand key terms and concepts. By repeating this process for every lesson in the course, you should be completely confident by your exam date.

Additionally, our courses include comprehensive practice tests that are designed in the style and format of actual MTEL exams. Take these practice exams to get familiar with the MTEL's question types and difficulty level. You can also use the practice test results to determine which topics you may need to spend more time studying. If you need any extra help along the way, we have you covered! The Ask the Expert feature allows you to submit any questions you may have about the course material. We've also made the courses accessible on any Internet-connected device and available at any time of day or night. This way, you can study for your MTEL exam wherever and whenever it's convenient.


Mass. Education Officials Review How Teachers Are Certified | killexams.com real questions and Pass4sure dumps

Massachusetts Secretary of Education Jim Peyser was recently the guest speaker at a public forum in Lexington. During the Q&A, someone asked him about teacher certification.

“I don’t really understand teacher certification as a necessary requirement for teachers to be in the field,” he replied.

Peyser, who was appointed by Gov. Charlie Baker, said he’s probably a little “radical” on this point. But his comment is also timely.

Right now, the state Department of Elementary and Secondary Education is reviewing how it certifies teachers. The goal: to simplify the process. So which elements to keep and which to drop? It depends who you ask.

At that forum, Peyser added: “Teacher certification is a requirement that all teachers must have, and it’s more of a bureaucratic exercise than one that actually, I think, has any connection -- at least from a research point of view, any connection — to teaching quality or student outcomes.”

The research is, in fact, quite mixed on this. We wanted to hear more from Peyser and requested an interview.

His office instead sent an email. “Secretary Peyser believes that teacher certification should be streamlined, not eliminated,” it said.

Massachusetts, like other states, has numerous levels of certification, starting with, if needed, “temporary” licenses for a limited time. Some requirements for licensure can be met while teaching. Every teacher in the state must have a bachelor’s degree and pass the Massachusetts Tests for Educator Licensure (MTEL) in their subject matter. After five years of experience, unless an extension is granted, teachers must seek “professional” licensure, and that requires a master’s degree.

While the advanced degree is a requirement for most Massachusetts teachers, it’s not required for teachers in charter schools, though many charter school teachers do have them.

Peyser, who wants to see more charter schools in the state, says certification shouldn’t be that complicated.

“In the charter sector, they’re required to take assessments ... that every other teacher is required to take, but they’re not required to do the coursework,” he told the Lexington forum. “They’re not required to have the other degrees or go through other hoops that other teachers have.”

Barbara Madeloni, the newly reelected head of the Massachusetts Teachers Association, said Peyser has it “completely backwards.”

"The level of disrespect for the profession [his statement] reveals, from our secretary of education, is actually kind of breathtaking,” she said.

A staunch critic of charter schools, Madeloni says if she’s not mistaken, she hears Peyser saying keep the MTEL standardized test for incoming teachers and get rid of the deep learning she says educators need.

We asked Madeloni and others the same question asked of those at the state department of education who, in the next few weeks, are reviewing certification requirements: “If you could change one thing about the existing regulation and licensure, what would you change?”

“As a teacher educator myself,” Madeloni replied, “I know the kind of work that it takes, the kinds of questions that people need to be taught to ask themselves, what it means to even craft a question to be an excellent educator. That takes time and learning and thoughtfulness, and can’t be tested. So the MTEL doesn’t let us know us know if somebody has that, and [it] can’t be rushed.”

Teaching requires an understanding of human development, psychology, the social context of teaching and learning and, Madeloni said, it requires a knowledge of self, in relation to all of that. This is what prospective teachers get when they take education courses, she added.

But that’s not what state Rep. Alice Peisch says she hears from teachers time and time again.

"The teacher preparation programs do not adequately prepare them to teach when they walk in the door,” she said in an interview.

Peisch, a Wellesley Democrat and House chair of Massachusetts’ Joint Committee on Education, says new teachers must demonstrate they can handle a classroom, no matter what kind of school.

“I would like to resist the temptation to compare charter and district schools as though all charters do this, and all district schools do that,” Peisch said.

Phil Rogers, executive director of the National Association of State Directors of Teacher Education and Certification, is watching a similar debate unfold across the country. He says as Massachusetts puts its teacher certification on a diet, others will be watching. He says all state governments have an add-on mentality when it comes to regulations.

“Now, I think, they’re trying to bring some of those features of high quality alternative certification programs into the regular certification programs,” Rogers said.

He responded similarly to others when asked about refining teacher certification. Candidates should demonstrate they know how to teach, he says, not just what to teach.

“[Teachers need to] understand basic elementary dimensions of educational psychology. You understand the things that happen in the transaction between a teacher and a student,” Rogers said. The student-teacher relationship is "incredibly complicated," he said. “And when you just say, ‘Oh, we just want someone who has a degree in math,’ you may get an excellent teacher. But it’s really, literally, a roll of the dice.”

That’s not a whole lot different from what Rachel Romano sees when she hires teachers at Veritas Prep Charter School in Springfield. She is now the executive director of the fifth through eighth grade school.

More than 10 years ago, Romano was a state-certified teacher who taught in a Springfield middle school. What would she change about teacher certification? A lot, she says, starting with giving license reciprocity to highly experienced teachers from other states.

"It is incredibly difficult to come into Massachusetts from another state, even if you are licensed and certified and have been teaching for a number of years. That seems silly to me,” Romano said.

As for the MTEL, that can stay, Romano says. Anyone who is going to work with students should be able to pass the MTEL. But Romano says Massachusetts gives master’s degrees too high a premium.

“On one hand, it’s like teachers need to be incredibly prepared to hit these classrooms,” Romano said. “They do need that master’s degree, but the master’s programs need to change. This is not a job that we sit around and talk about what we’re going to do. It’s a doing job.”

To get licensed, Romano -- who has a master's degree -- says teachers first need to know how to engage kids and how to get them to stop talking. Unless you’re a curriculum developer, she says, you can skip that class on major 20th century child development theories. For now.

So where might the head of a charter school and the head of a teacher’s union see common ground? If teachers don’t have what they need when they land in the front of a class of 30 kids -- even if they’re certified -- they feel like they failed, and they leave the field.

Everyone watching agrees: That’s got to change.

This story was originally published by New England Public Radio.


2.7M voters in Massachusetts cast votes on Tuesday | killexams.com real questions and Pass4sure dumps

   THE HOUSE AND SENATE: Secretary of State Bill Galvin announced that unofficial, incomplete results indicate that the 2018 midterm election saw 2.7 million voters cast their ballots – more in a midterm election than ever before in the Bay State.  The number of voters continues to rise as local election officials count military and overseas ballots and provisional ballots cast on Election Day.

The new session of the Massachusetts Legislature that begins on January 3, 2019 will open with 127 Democrats, 32 Republicans and one Independent in the House. The Senate membership will be made up of 34 Democrats and six members of the GOP. These numbers are pretty close to the makeup of the 2017-2018 session.

Democrats defeated one incumbent Republican House member and toppled one GOP senator. Eight-year incumbent Republican Rep. James Lyons (R-Andover) lost his seat to Democrat Tram Nguyen. Democrat Rebecca Rausch defeated eight-year incumbent Republican Sen. Richard Ross (R-Wrentham). Ross had also served six years in the House before being elected to the Senate in 2011.

There were no roll calls in the House or Senate last week. This week Beacon Hill Roll Call begins a series of report on how local legislators in 2017-2018 voted on roll calls raising, lowering or creating new taxes.

First up: Part one of a two-part series of reports on House members’ votes on eight tax proposals.

DELAY PERMANENT SALES TAX HOLIDAY (H 3600)

   House 119-38, approved a Democratic leadership-sponsored amendment indefinitely delaying a Republican proposal to establish a permanent annual two-day weekend sales tax holiday in August. The amendment would require the Baker administration to study the impact the reduction would have on the state.

(A "Yes" vote is for the delay. A "No" vote is against the delay.)

Rep. Carole Fiola Yes                                    Rep. Patricia Haddad Yes                                    Rep. Steven Howitt No                                     Rep. Christopher Markey Yes                                    Rep. Paul Schmid Yes                                    Rep. Alan Silvia Yes                                    

 

DELAY PERMANENT MEALS TAX HOLIDAY (H 3600)

   House 117-39, approved a Democratic-sponsored amendment indefinitely delaying a Republican-sponsored proposal that would permanently exempt diners from paying the state’s 6.25 percent meals tax each year from March 22-27. The amendment would require the state to study the impact of the tax holiday on the state’s economy.

 (A "Yes" vote is for the delay. A "No" vote is against the delay.)

Rep. Carole Fiola Yes                                    Rep. Patricia Haddad Yes                                    Rep. Steven Howitt No                                     Rep. Christopher Markey Yes                                    Rep. Paul Schmid Yes                                    Rep. Alan Silvia Yes                                    

DELAY REDUCTION IN SALES TAX FROM 6.25 PERCENT TO 5 PERCENT (H 3600)

House 118-39, approved a Democratic-sponsored amendment indefinitely delaying a Republican-sponsored proposal that would reduce the state's sales tax from 6.25 percent to 5 percent.

The amendment would require the state to study the impact of the tax reduction on the state’s economy.

(A "Yes" vote is for the delay. A "No" vote is against the delay.)

Rep. Carole Fiola Yes                                    Rep. Patricia Haddad Yes                                    Rep. Steven Howitt No                                     Rep. Christopher Markey Yes                                    Rep. Paul Schmid Yes                                    Rep. Alan Silvia Yes                                    

 

REDUCE INCOME TAX RATE TO 5 PERCENT (H 3600)

House 36-123, rejected an amendment reducing the income tax from 5.1 percent to 5 percent.

(A "Yes" vote is for the reduction. A "No" vote is against it.)

Rep. Carole Fiola No                                     Rep. Patricia Haddad No                                     Rep. Steven Howitt Yes                                    Rep. Christopher Markey No                                     Rep. Paul Schmid No                                     Rep. Alan Silvia No                                     

 

ADOPTION TAX CREDIT (H 3600)

House 47-110, rejected an amendment that would give adoptive parents up to a $1,000 tax credit to cover adoption expenses.

(A "Yes" vote is for the $1,000 tax credit. A "No" vote is against it.)

Rep. Carole Fiola No                                     Rep. Patricia Haddad No                                     Rep. Steven Howitt Yes                                    Rep. Christopher Markey Yes                                    Rep. Paul Schmid No                                     Rep. Alan Silvia Yes                                    

 

4 PERCENT TAX HIKE ON MILLIONAIRES (H 3933)

House approved 105-48, approved a proposed constitutional amendment that would allow a graduated income tax in Massachusetts and impose an additional 4 percent income tax, in addition to the current flat 5.1 percent one, on taxpayers’ earnings of more than $1 million.

The proposal was supposed to go on the November ballot for voters to decide but the Supreme Judicial Court ruled that the amendment was unconstitutional because the constitution prohibits placing more than one objective in a single proposed constitutional amendment. The decision noted that the proposal imposes the tax and then stipulates how the money could be spent.

(A "Yes" vote is for the additional 4 percent tax. A "No" vote is against it.)

Rep. Carole Fiola Yes                                    Rep. Patricia Haddad Yes                                    Rep. Steven Howitt No                                     Rep. Christopher Markey No                                     Rep. Paul Schmid Yes                                    Rep. Alan Silvia Yes                                    

 

REGULATION AND TAXING OF SHORT-TERM RENTALS (H 4841)

 House 119-30, approved and sent to the governor a measure that extends the state’s current 5.7 percent hotel and motel tax and up to a 6 percent local option room occupancy tax to short-term rentals offered by Airbnb, HomeAway and VRBO while leaving the regulation of these rentals including registration, licensing and inspections up to local cities and towns.

 Gov. Baker proposed some amendments to the bill and the Legislature has not yet acted on his amendments so the bill remains unsigned.

The measure also allows local cities and towns to impose a local impact fee of up to 3 percent on operators who rent out two or more professionally-managed short-term rental units within a municipality.

Other provisions create a central state registry of short-term rentals and require that a city or town dedicate no less than 35 percent of revenue generated from the new local option fee to either affordable housing or local infrastructure needs.

(A "Yes" vote is for the bill. A "No" vote is against it.)

Rep. Carole Fiola Yes                                    Rep. Patricia Haddad Yes                                    Rep. Steven Howitt No                                     Rep. Christopher Markey Yes                                    Rep. Paul Schmid Yes                                    Rep. Alan Silvia Yes                                    

 

HIKE CAR RENTAL TAX BY $2 TO FUND POLICE TRAINING (H 4516)

House 144-4, approved and Gov. Baker signed into law a bill imposing a $2 tax on car rentals to fund municipal police training.

  (A "Yes" vote is for the $2 tax to fund police training. A "No" vote is against it.)

Rep. Carole Fiola Yes                                    Rep. Patricia Haddad Yes                                    Rep. Steven Howitt Yes                                    Rep. Christopher Markey Yes                                    Rep. Paul Schmid Yes                                    Rep. Alan Silvia Yes                                    

 ALSO UP ON BEACON HILL

CIVIC EDUCATION IN SCHOOLS (S 2631) – Gov. Charlie Baker signed into law a bill will require Massachusetts public high schools and school districts serving eighth-grade students to provide at least one individual, small group, or class wide, student-led, non-partisan civics project for each student. The projects must be designed to promote student abilities related to the analysis of complex issues; consideration of different perspectives; engagement in civil discourse; and understanding of the connections between federal, state, and local policies. Another key provision establishes a Civics Project Trust Fund which will be used to create a statewide civic infrastructure and provide professional development to teachers, prioritizing underserved communities in "school districts with high concentrations of economically disadvantaged students."

"This bill could not have come at a better time," said Arielle Jennings, Massachusetts Executive Director of Generation Citizen, a group that was at the forefront of the campaign to get this measure signed into law. "We are in a moment when so many young people are seeing the power of youth voice on the national stage and are eager to participate in the civic and political process. In order to do so, youth need educational experiences to help develop their civic skills and knowledge and real-world civic engagement opportunities that show them the political process is relevant to their lives."

According to Generation Citizen, only one in four Americans can name the three branches of government and voting rates of young adults are at an historic low. Lower-income students often receive lower-quality civic learning education at school and demonstrate significantly lower levels of achievement in standardized tests of civics than their higher-income peers.

"This bill ensures that all students throughout the commonwealth will be exposed to robust civics curricula in order to prepare them to be informed and thoughtful participants in our democracy," said Rep. Alice Peisch (D-Wellesley), House Chair of the Education Committee. "This bill, in conjunction with the Department’s new History and Social Science Curriculum Framework and a new assessment aligned with these standards, are critical to preparing students for a lifetime of civic responsibility."

 "I am incredibly proud that this bill is being signed into law because comprehensive civics education leads to more informed voters, better public policies, and a superior Commonwealth," said Sen.  Harriette  Chandler (D-Worcester). "So much work went into this bill: from the legislators to the educators, to the administrators, the students and the advocates, we could not have made this effort a reality without your hard work and dedication."

   "Massachusetts has moved forward to a leadership role on civics education," said Steven Rothstein the executive director of the John F. Kennedy Library and the co-founder of the Mass Civics Learning Coalition. "This legislation will ensure that every student is ready for civic life. This is especially important at this time."

   TRAINING TO HELP COMBAT ELDER FINANCIAL ABUSE – Secretary of State Bill Galvin unveiled a new training program to provide state and local law enforcement officials with free training and resources to help them recognize the red flags of elder financial abuse and fraud. "It is important for my office to collaborate with law enforcement throughout the commonwealth to combat elder financial abuse and securities fraud," said Galvin.

  The training highlights common schemes and hallmarks of financial abuse that harm older adults and others. It also provides law enforcement officers with resources on how to recognize warning signs and how to report suspected problems to collaborating agencies such as the Massachusetts Securities Division.

   For more information or to set up a training program in your community contact the Massachusetts Securities Division at 617-727-3548.

    SCHOOLS MUST REPORT ALL THREATS (H 302) - Approved by the House on June 8, 2017 and still stuck in the House Committee on Bills in Third Reading Committee is a bill that would change a current law that requires principals of all public and private school to immediately report to the local fire department any incidents involving the setting of unauthorized fires within a school building or on school grounds. The measure would expand the law and require the principals to report all threats including biological hazards, shootings or cyber threats.

   FINANCIAL LITERACY (S 2343) -  Approved by the Senate on March 2018 and still stuck in the House Ways and Means Committee is a bill that would require the state to develop and allow cities and towns to institute a program to teach financial literacy to students in kindergarten to grade 12. The topics covered would include understanding banking and financial services, loans, interest, credit cards, online commerce, renting or buying a home, balancing a checkbook, state and federal taxes and charitable giving.

  MANY BILLS SENT TO STUDY COMMITTEE – Hundreds of bills were sent off to a study committee in the 2017-2018 session. Most measures that are shipped off to a study committee are never actually studied and are essentially defeated. Here are some of the unlucky bills:

   MUST REGISTER BIKES WITH REGISTRY OF MOTOR VEHICLES (H 1832) - Requires anyone age 21 and older to register his or her bicycle biannually with the Registry of Motor Vehicles. The state would establish a fee and issue a license plate that the bicyclist would be required to attach to his or her bike.

   WEAR REFLECTIVE MATERIAL (H 1854) - Requires anyone walking outdoors in an unilluminated area after dusk to wear reflective material or carry a luminescent device like a flashlight, lantern or the flashlight application on a cell phone in order to help prevent accidents.

  ORGAN DONORS (H 3434) - Automatically enrolls anyone who applies for or renews a driver’s license in the state’s organ donor program. The person could opt out of the program by signing a written notice. Current law only enrolls people who voluntarily sign up for the program when applying for or renewing their driver’s license.

  TAX SUGARY DRINKS (H 3329) - Taxes sugary soft drinks which are currently exempt from the state’s 6.25 percent sales tax.

 



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References :


Dropmark : http://killexams.dropmark.com/367904/11571829
Wordpress : http://wp.me/p7SJ6L-GB
Issu : https://issuu.com/home/publications
Dropmark-Text : http://killexams.dropmark.com/367904/12092077
weSRCH : https://www.wesrch.com/business/prpdfBU1HWO000ADJN
Blogspot : http://killexams-braindumps.blogspot.com/2017/11/free-pass4sure-mtel-question-bank.html
RSS Feed : http://feeds.feedburner.com/EnsureYourSuccessWithThisMtelQuestionBank
Youtube : https://youtu.be/HxsntLlyCRQ
Google+ : https://plus.google.com/112153555852933435691/posts/3bgjTUZSxJx?hl=en
publitas.com : https://view.publitas.com/trutrainers-inc/exactly-same-mtel-questions-as-in-real-test-wtf
Calameo : http://en.calameo.com/books/004923526a42c5255df04
Box.net : https://app.box.com/s/fvlmy07w09tel56yj674ax6v69333lhl
zoho.com : https://docs.zoho.com/file/3u6up2e87bedc4b5149b4947b448d278ef866






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